Independent Prognostic Value of Serum Markers in Diffuse Large B-Cell Lymphoma in the Era of the NCCN-IPI.

Abstract

BACKGROUND:

Several serum parameters have been evaluated for adding prognostic value to clinical scoring systems in diffuse large B-cell lymphoma (DLBCL), but none of the reports used multivariate testing of more than one parameter at a time. The goal of this study was to validate widely available serum parameters for their independent prognostic impact in the era of the National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) score to determine which were the most useful.

PATIENTS AND METHODS:

This retrospective bicenter analysis includes 515 unselected patients with DLBCL who were treated with rituximab and anthracycline-based chemoimmunotherapy between 2004 and January 2014.

RESULTS:

Anemia, high C-reactive protein, and high bilirubin levels had an independent prognostic value for survival in multivariate analyses in addition to the NCCN-IPI, whereas neutrophil-to-lymphocyte ratio, high gamma-glutamyl transferase levels, and platelets-to-lymphocyte ratio did not.

CONCLUSIONS:

In our cohort, we describe the most promising markers to improve the NCCN-IPI. Anemia and high C-reactive protein levels retain their power in multivariate testing even in the era of the NCCN-IPI. The negative role of high bilirubin levels may be associated as a marker of liver function. Further studies are warranted to incorporate these markers into prognostic models and define their role opposite novel molecular markers.

• Authors: Thomas Melchardt, Katharina Troppan, Lukas Weiss, Clemens Hufnagl, Daniel Neureiter, Wolfgang Tränkenschuh, Konstantin Schlick, Florian Huemer, Alexander Deutsch, Peter Neumeister, Richard Greil, Martin Pichler, Alexander Egle
• Journal: Journal of the National Comprehensive Cancer Network : JNCCN (J Natl Compr Canc Netw) Vol. 13 Issue 12 Pg. 1501-8 (Dec 2015) ISSN: 1540-1413 [Electronic] United States
• PMID: 26656519 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 by the National Comprehensive Cancer Network.

Chemical References

• Anthracyclines
• Biomarkers
• Inflammation Mediators
• Rituximab

Topics

• Adult
• Aged
• Aged, 80 and over
• Anthracyclines (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers (blood)
• Female
• Follow-Up Studies
• Humans
• Inflammation Mediators (metabolism)
• Liver (metabolism)
• Lymphoma, Large B-Cell, Diffuse (blood, drug therapy, mortality, pathology)
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Rituximab (administration & dosage)
• Survival Analysis
• Treatment Outcome
• Young Adult