Hugo J A Adams1, John M H de Klerk2, Rob Fijnheer3, Ben G F Heggelman4, Stefan V Dubois5, Rutger A J Nievelstein6, Thomas C Kwee6. 1. Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: h.j.a.adams@gmail.com. 2. Department of Nuclear Medicine, Meander Medical Center, Amersfoort, The Netherlands. 3. Department of Hematology, Meander Medical Center, Amersfoort, The Netherlands. 4. Department of Radiology, Meander Medical Center, Amersfoort, The Netherlands. 5. Department of Pathology, Meander Medical Center, Amersfoort, The Netherlands. 6. Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Abstract
PURPOSE: To determine the prognostic value of pretreatment anemia, pretreatment elevated C-reactive protein (CRP) levels, and 6-month posttreatment anemia in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, hydroxydaunorubicin, Oncovin, and prednisolone (R-CHOP). PATIENTS AND METHODS: A total of 104 patients with newly diagnosed DLBCL were retrospectively included. Pretreatment hemoglobin and CRP levels and 6-month posttreatment hemoglobin levels were measured. Cox regression analyses were used to determine the associations of laboratory assessments and National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) risk groups with progression-free survival (PFS) and overall survival (OS). RESULTS: Pretreatment anemia, elevated pretreatment CRP levels, and higher risk NCCN-IPI groups were significantly associated with reduced PFS and OS (P = .001 and P = .003 for pretreatment anemia, P = .035 and P = .029 for elevated CRP, and P < .001 and P < .001 for higher risk NCCN-IPI groups). On multivariate Cox regression analysis, only the NCCN-IPI risk group remained as an independent significant predictor for PFS (P < .001) and OS (P < .001). In the subgroup of patients in complete remission 6 months after chemotherapy (n = 80), 6-month posttreatment anemia was significantly associated with reduced PFS (P = .046) but not OS (P = .062), and higher risk NCCN-IPI groups were significantly associated with both reduced PFS (P = .008) and OS (P = .017). On multivariate Cox regression analysis, only the NCCN-IPI group remained an independent significant predictor for PFS (P = .008) and OS (P = .017). CONCLUSION: Pretreatment anemia, pretreatment CRP levels, and 6-month posttreatment anemia are significantly associated with poor outcome, but were not proven to be of additional prognostic value to the current risk stratification index for DLBCL.
PURPOSE: To determine the prognostic value of pretreatment anemia, pretreatment elevated C-reactive protein (CRP) levels, and 6-month posttreatment anemia in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, hydroxydaunorubicin, Oncovin, and prednisolone (R-CHOP). PATIENTS AND METHODS: A total of 104 patients with newly diagnosed DLBCL were retrospectively included. Pretreatment hemoglobin and CRP levels and 6-month posttreatment hemoglobin levels were measured. Cox regression analyses were used to determine the associations of laboratory assessments and National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) risk groups with progression-free survival (PFS) and overall survival (OS). RESULTS: Pretreatment anemia, elevated pretreatment CRP levels, and higher risk NCCN-IPI groups were significantly associated with reduced PFS and OS (P = .001 and P = .003 for pretreatment anemia, P = .035 and P = .029 for elevated CRP, and P < .001 and P < .001 for higher risk NCCN-IPI groups). On multivariate Cox regression analysis, only the NCCN-IPI risk group remained as an independent significant predictor for PFS (P < .001) and OS (P < .001). In the subgroup of patients in complete remission 6 months after chemotherapy (n = 80), 6-month posttreatment anemia was significantly associated with reduced PFS (P = .046) but not OS (P = .062), and higher risk NCCN-IPI groups were significantly associated with both reduced PFS (P = .008) and OS (P = .017). On multivariate Cox regression analysis, only the NCCN-IPI group remained an independent significant predictor for PFS (P = .008) and OS (P = .017). CONCLUSION: Pretreatment anemia, pretreatment CRP levels, and 6-month posttreatment anemia are significantly associated with poor outcome, but were not proven to be of additional prognostic value to the current risk stratification index for DLBCL.
Authors: Michael R Clausen; Matthew J Maurer; Sinna Pilgaard Ulrichsen; Thomas S Larsen; Bodil Himmelstrup; Dorthe Rønnov-Jessen; Brian K Link; Andrew L Feldman; Susan L Slager; Grzegorz S Nowakowski; Carrie A Thompson; Per Trøllund Pedersen; Jakob Madsen; Robert S Pedersen; Jette Sønderskov Gørløv; James R Cerhan; Mette Nørgaard; Francesco D'Amore Journal: Clin Epidemiol Date: 2019-11-14 Impact factor: 4.790
Authors: Kim Oren Gradel; Thomas Stauffer Larsen; Henrik Frederiksen; Pernille Just Vinholt; Maria Iachina; Pedro Póvoa; Fernando Godinho Zampieri; Stig Lønberg Nielsen; Ram Benny Dessau; Jens Kjølseth Møller; Thøger Gorm Jensen; Ming Chen; John Eugenio Coia; Jelena Jelicic Journal: Ann Med Date: 2022-12 Impact factor: 4.709