Format

Send to

Choose Destination
Br J Cancer. 2016 Nov 8;115(10):1264-1272. doi: 10.1038/bjc.2016.325. Epub 2016 Oct 20.

NCCN-IPI score-independent prognostic potential of pretreatment uric acid levels for clinical outcome of diffuse large B-cell lymphoma patients.

Author information

1
Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria.
2
Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria.
3
Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria.
4
Institute of Pathology, Medical University of Graz (MUG), Graz 8036, Austria.
5
Division of Angiology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria.
6
Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg 5020, Austria.
7
Research Unit for non-coding RNAs and genome editing in cancer, Graz 8036, Austria.
8
Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA.

Abstract

BACKGROUND:

Blood-based parameters are gaining increasing interest as potential prognostic biomarkers in patients with diffuse large B-cell lymphoma (DLBCL). The aim of this study was to comprehensively evaluate the prognostic significance of pretreatment plasma uric acid levels in patients with newly diagnosed DLBCL.

METHODS:

The clinical course of 539 DLBCL patients, diagnosed and treated between 2004 and 2013 at two Austrian high-volume centres with rituximab-based immunochemotherapy was evaluated retrospectively. The prognostic influence of uric acid on overall survival (OS) and progression-free survival (PFS) were studied including multi-state modelling, and analysis of conditional survival.

RESULTS:

Five-year OS and PFS were 50.4% (95% CI: 39.2-60.6) and 44.0% (33.4-54.0) in patients with uric acid levels above the 75th percentile of the uric acid distribution (Q3, cut-off: 6.8 mg dl-1), and 66.2% (60.4-71.5) and 59.6% (53.7-65.0%) in patients with lower levels (log-rank P=0.002 and P=0.0045, respectively). In univariable time-to-event analysis, elevated uric acid levels were associated with a worse PFS (hazard ratio (HR) per 1 log increase in uric acid 1.47, 95% CI: 1.10-1.97, P=0.009) and a worse OS (HR=1.60, 95% CI: 1.16-2.19, P=0.004). These associations prevailed upon multivariable adjustment for the NCCN-IPI score. Uric acid levels significantly improved the predictive performance of the R-IPI and NCCN-IPI scores, and in multi-state analysis, it emerged as a highly significant predictor of an increased risk of death without developing recurrence (transition-HR=4.47, 95% CI: 2.17-9.23, P<0.0001).

CONCLUSIONS:

We demonstrate that elevated uric acid levels predict poor long-term outcomes in DLBCL patients beyond the NCCN-IPI risk index.

PMID:
27764838
PMCID:
PMC5104895
DOI:
10.1038/bjc.2016.325
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central
Loading ...
Support Center