NCCN-IPI score-independent prognostic potential of pretreatment uric acid levels for clinical outcome of diffuse large B-cell lymphoma patients.
NCCN-IPI score-independent prognostic potential of pretreatment uric acid levels for clinical outcome of diffuse large B-cell lymphoma patients.
复制标题
DOI：
10.1038/bjc.2016.325
复制
发表时间：
2016-11-08
影响因子：
8.8
通讯作者：
Pichler, Martin
中科院分区：
文献类型：
--
作者：
Prochazka, Katharina T.;Melchardt, Thomas;Posch, Florian;Schlick, Konstantin;Deutsch, Alexander;Beham-Schmid, Christine;Weiss, Lukas;Gary, Thomas;Neureiter, Daniel;Klieser, Eckhard;Greil, Richard;Neumeister, Peter;Egle, Alexander;Pichler, Martin
基于血液的参数作为弥漫性大B细胞淋巴瘤（DLBCL）患者的潜在预后生物标志物越来越受到关注。本研究的目的是综合评价治疗前血浆尿酸水平对新诊断DLBCL患者的预后意义。回顾性评估了2004年至2013年期间在两个奥地利高容量中心使用基于利妥昔单抗的免疫化疗诊断和治疗的539例DLBCL患者的临床病程。研究了尿酸对总生存期（OS）和无进展生存期（PFS）的预后影响，包括多状态建模和条件生存期分析。5年OS和PFS为50.4%（95% CI：39.2-60.6）和44.0%（33.4-54.0）在尿酸水平高于尿酸分布第75百分位数的患者中（Q3，临界值：6.8 mg dl−1），低水平患者中分别为66.2%（60.4-71.5）和59.6%（53.7-65.0%）（对数秩分别为P=0.002和P=0.0045）。在单变量至事件发生时间分析中，尿酸水平升高与PFS恶化（尿酸每增加1个对数的风险比（HR）为1.47，95% CI：1.10-1.97，P=0.009）和OS恶化（HR=1.60，95% CI：1.16-2.19，P=0.004）相关。这些关联在NCCN-IPI评分的多变量调整后占优势。尿酸水平显著改善了R-IPI和NCCN-IPI评分的预测性能，在多状态分析中，尿酸水平是死亡风险增加而不发生复发的高度显著预测因素（过渡HR =4.47，95%CI：2.17-9.23，P<0.0001）。我们证明，超出NCCN-IPI风险指数，尿酸水平升高预测DLBCL患者的长期结局较差。
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. 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. 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). We demonstrate that elevated uric acid levels predict poor long-term outcomes in DLBCL patients beyond the NCCN-IPI risk index.
登录
查看更多内容
影响因子：
50.5
作者：
Tilly, H.;Vitolo, U.;Grp, E. S. M. O. Guidelines Working
通讯作者：
Grp, E. S. M. O. Guidelines Working
影响因子：
2
作者：
Marubini, E;Morabito, A;Valsecchi, M G
通讯作者：
Valsecchi, M G
影响因子：
3.4
作者：
Selcukbiricik, F.;Kanbay, M.;Mandel, N. M.
通讯作者：
Mandel, N. M.
影响因子：
64.8
作者：
Alizadeh, AA;Eisen, MB;Staudt, LM
通讯作者：
Staudt, LM
影响因子：
8.8
作者：
Troppan, K.;Deutsch, A.;Gerger, A.;Stojakovic, T.;Beham-Schmid, C.;Wenzl, K.;Neumeister, P.;Pichler, M.
通讯作者：
Pichler, M.