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J Natl Compr Canc Netw. 2015 Dec;13(12):1501-8.

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

Author information

1
From the Department of Internal Medicine III, Cancer Research Institute, Paracelsus Medical University Salzburg, Salzburg, Austria; Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria; and Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Duarte, Texas.

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.

PMID:
26656519
[Indexed for MEDLINE]

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