Journal
FRONTIERS IN ONCOLOGY
Volume 10, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2020.610681
Keywords
diffuse large B-cell lymphoma; albumin; survival; change; outcome
Categories
Funding
- Outstanding Youth Development Scheme of Nanfang Hospital, Southern Medical University [2019J011]
- National Natural Science Foundation of Guangdong Province and Guangzhou City [2018A030313083, 201804010351]
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Consecutive hypoalbuminemia is a simple and effective adverse prognostic factor in patients with diffuse large B-cell lymphoma (DLBCL), independent of International Prognostic Index (IPI), highlighting the importance of monitoring patients with low serum albumin at the end-of-treatment (EoT) for better outcomes during follow-up.
The prognostic value of albumin changes between diagnosis and end-of-treatment (EoT) in diffuse large B-cell lymphoma (DLBCL) remains unknown. We retrospectively analyzed 574 de novo DLBCL patients treated with R-CHOP from our and two other centers. All patients were divided into a training cohort (n = 278) and validation cohort (n = 296) depending on the source of the patients. Overall survival (OS) and progression-free survival (PFS) were analyzed by the method of Kaplan-Meier and Cox proportional hazard regression model. In the training cohort, 163 (58.6%) patients had low serum albumin at diagnosis, and 80 of them were present with consecutive hypoalbuminemia at EoT. Patients with consecutive hypoalbuminemia showed inferior OS and PFS (p = 0.010 and p = 0.079, respectively). Similar survival differences were also observed in the independent validation cohort (p = 0.006 and p = 0.030, respectively). Multivariable analysis revealed that consecutive hypoalbuminemia was an independent prognostic factor OS [relative risk (RR), 2.249; 95% confidence interval (CI), 1.441-3.509, p < 0.001] and PFS (RR, 2.001; 95% CI, 1.443-2.773, p < 0.001) in all DLBCL patients independent of IPI. In conclusion, consecutive hypoalbuminemia is a simple and effective adverse prognostic factor in patients with DLBCL, which reminds us to pay more attention to patients with low serum albumin at EoT during follow-up.
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