Albumin improves stratification in the low IPI risk patients with diffuse large B-cell lymphoma
Albumin improves stratification in the low IPI risk patients with diffuse large B-cell lymphoma
复制标题
白蛋白可改善低 IPI 风险的弥漫性大 B 细胞淋巴瘤患者的分层
DOI：
10.1007/s12185-020-02818-9
复制
发表时间：
2020-01-28
影响因子：
2.1
通讯作者：
Feng, Ru
中科院分区：
文献类型：
--
作者：
Wei, Yongqiang;Wei, Xiaolei;Feng, Ru
既往研究显示，诊断时的白蛋白可用于预测弥漫性大B细胞淋巴瘤（DLBCL）患者的结局，但白蛋白是否能改善国际预后指数（IPI）风险分层仍不清楚。在此，我们回顾性分析了本研究中的440例原发DLBCL患者。白蛋白的临界值为39.2 g/L。高血清白蛋白患者的OS和PFS较好（分别为p= 0.002和p < 0.001）。根据IPI，低危组163例（37.0%），低-中危组107例（24.3%），高-中危组114例（25.9%），高危组56例（12.7%）。进一步分析显示，高白蛋白可以识别出低IPI风险患者中具有极优上级OS和PFS的患者亚组（分别为p= 0.022和p = 0.034）。多变量分析显示，高白蛋白是OS（相对比[RR] 0.122; 95%可信区间[CI] 0.021- 0.715，p = 0.020）和PFS趋势（RR 0.417; 95%CI 0.168- 1.035，p = 0.059）的独立预后因素。总之，我们的研究表明，诊断时的白蛋白是DLBCL患者的一个简单而有效的预后因素，可以在低风险患者中识别出一个上级的结局亚组，这可能有助于指导临床试验中的治疗。
Previous studies showed albumin at diagnosis could be used to predict outcome in patients with diffuse large B-cell lymphoma (DLBCL), but whether albumin could improve the international prognostic index (IPI) risk stratification remains unknown. Herein, we retrospectively analyzed 440 de novo DLBCL patients in this study. The cutoff value of albumin was 39.2 g/L. Patients with high serum albumin showed superior OS and PFS (p= 0.002 andp< 0.001, respectively). According to IPI, there were 163 patients (37.0%) in low-risk group, 107 (24.3%) in low-intermediate risk group, 114 (25.9%) in high-intermediate risk group and 56 (12.7%) in high-risk group. Further analysis showed high albumin could identify a subgroup of patients with extremely superior OS and PFS in low IPI risk patients (p= 0.022 andp= 0.034, respectively). Multivariate analysis revealed that high albumin was an independent prognostic factor for OS (relative ratio [RR] 0.122; 95% confidence interval [CI] 0.021–0.715,p= 0.020) and trend for PFS (RR 0.417; 95% CI 0.168–1.035,p= 0.059). In conclusion, our study suggests that albumin at diagnosis is a simple and effective prognostic factor in DLBCL patients, allowing the identification of a superior outcome subgroup in low-risk patients, which may help to guide treatment in clinical trial.