Presence of multiple abnormal immunologic markers is an independent prognostic factor of diffuse large B-cell lymphoma

Abstract

Autoimmune diseases (ADs) increase the risk of non-Hodgkin’s lymphoma and contribute to poor prognosis of patients. However, the association between immunologic markers and clinical outcome has rarely been investigated. This study aims to analyze the prognostic value of pretreatment immunologic markers in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively reviewed the data on 502 patients with DLBCL treated in our institution from January 2013 to March 2018. Survival functions were estimated using Kaplan–Meier method and Cox regression model. The 3-year progression free survival (PFS) and overall survival (OS) rates were 70.2% and 80.9%, respectively, and the complete remission (CR) rate was 78.1%. Among the patients, those with multiple (≥3) abnormal immunologic markers had significantly shorter 3-year PFS (52.7% vs. 77.3%, P<0.001) and OS (68.5% vs. 85.8%, P=0.001) than those without multiple abnormal immunologic markers. Multivariate analysis revealed that the presence of multiple abnormal immunologic markers and the elevated serum levels of lactate dehydrogenase were the independent adverse prognostic factors for PFS (P=0.008, P<0.001) and OS (P=0.003, P<0.001). Meanwhile, advanced Ann Arbor stage was an independent adverse prognostic factor for PFS (P=0.001) and age>60 years for OS (P=0.014). In conclusion, the immunologic status was closely related to lymphoma progression, and this study provides new insights into the risk stratification of patients with DLBCL.

Keywords

immunologic marker / diffuse large B-cell lymphoma / prognosis

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Acknowledgements

This study is supported, in part, by research funding from the National Natural Science Foundation of China (Nos. 81520108003, 81670716, and 81830007), the Shanghai Commission of Science and Technology (No. 16JC1405800), Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support (Nos. 20152206 and 20152208), Clinical Research Plan of SHDC (No. 16CR2017A), Multicenter Clinical Research Project by Shanghai Jiao Tong University School of Medicine (No. DLY201601), Collaborative Innovation Center of Systems Biomedicine and the Samuel Waxman Cancer Research Foundation.

Compliance with ethics guidelines

Yiwen Cao, Zhenhua Liu, Wen Wu, Ying Qian, Qin Shi, Rong Shen, Binshen Ouyang, Pengpeng Xu, Shu Cheng, Jin Ye, Yiming Lu, Chaofu Wang, Chengde Yang, Li Wang, and Weili Zhao declare no conflict of interest. All included procedures were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and the Helsinki Declaration. Informed consent was obtained from all patients upon enrollment in the study.

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2019 The Author(s) 2019. This article is published with open access at link.springer.com and journal.hep.com.cn