PRETREATMENT CRP LEVEL IN DLBCL PATIENTS: AN IMPORTANT PREDICTOR OF TREATMENT RESPONSE IN RESOURCE CONSTRAINT SETTINGS.
(Abstract release date: 05/19/16)
EHA Library. Jain N. 06/09/16; 134607; PB1707
Dr. Nidhi Jain
Contributions
Contributions
Abstract
Abstract: PB1707
Type: Publication Only
Background
The currently available prognostic model for Diffuse Large B Cell Lymphoma (DLBCL) is not sufficient to predict the outcome of this heterogenous group of DLBCL. There is a need to find better prognostic markers for optimal risk stratification of DLBCL patients.
Aims
This study aimed to evaluate the prognostic significance of proinflammatory markers in pretreatment peripheral blood sample of patients of DLBCL.
Methods
We measured levels of CRP and Th1 and Th2 cytokines (IL2, IL4, IL6, IL10, IFN gammaand TNF alpha) in the pretreatment serum of 46 newly diagnosed DLBCL patients and in 10healthy controls. CRP was measured by nephelometry and cytokines were measured usingflowcytometric bead array assay. We compared the levels of these proinflammatory markers between cases and control groups. We evaluated the correlation of levels of these proinflammatory markers with disease characteristics like B symptoms, Ann Arbor stage, IPI and with treatment response.
Results
The median age of cases was 55 years (range 13-80 years) while that of controls was46 years. Among DLBCL patients 72% were males and 28% were females. According to theIPI scoring the low, intermediate and high risk groups comprised of 28%, 28%, and 44%patients respectively. Of the 41 patients who received treatment, 58% achieved CR, 12%achieved PR and 24% had progressive disease respectively after frontline treatment withchemotherapy. In this study we found that the levels of CRP, IL4, IL6, IL10 and IFNgamma were significantly elevated in DLBCL patients as compared to the control group as shown in Table 1. The pretreatment serum level of CRP in DLBCL patients was significantly elevated in those with B symptoms and high risk IPI group as compared to those without B symptoms and low risk IPI respectively. It was also noted that IL2 showed a significant inverse correlation with stage and IPI of DLBCL patients. The median serum value of CRP was 30.5mg/l and 81mg/l in patients who achieved complete remission (CR) and those who did not achieve CR respectively after the frontline chemotherapy (p value - 0.007). The median serum level of IL6 was 31.5pg/ml and 14pg/ml respectively in those who achieved overall response (OR) and those who did not achieve. Thus OR was significantly lower in those patients with elevated IL6 (p value - 0.05).
Conclusion
Pro inflammatory markers can be used to predict treatment outcome in DLBCL patients. Our work concludes that there is alteration in cytokine profile of patients with DLBCL with inclination towards heightened Th2 response. CRP has shown a significant correlation with adverse disease characteristics and treatment response. It can emerge as a readily available and cost effective prognostic marker to predict treatment response in DLBCL patients especially in resource constraint settings.
Session topic: E-poster
Keyword(s): DLBCL
Type: Publication Only
Background
The currently available prognostic model for Diffuse Large B Cell Lymphoma (DLBCL) is not sufficient to predict the outcome of this heterogenous group of DLBCL. There is a need to find better prognostic markers for optimal risk stratification of DLBCL patients.
Aims
This study aimed to evaluate the prognostic significance of proinflammatory markers in pretreatment peripheral blood sample of patients of DLBCL.
Methods
We measured levels of CRP and Th1 and Th2 cytokines (IL2, IL4, IL6, IL10, IFN gammaand TNF alpha) in the pretreatment serum of 46 newly diagnosed DLBCL patients and in 10healthy controls. CRP was measured by nephelometry and cytokines were measured usingflowcytometric bead array assay. We compared the levels of these proinflammatory markers between cases and control groups. We evaluated the correlation of levels of these proinflammatory markers with disease characteristics like B symptoms, Ann Arbor stage, IPI and with treatment response.
Results
The median age of cases was 55 years (range 13-80 years) while that of controls was46 years. Among DLBCL patients 72% were males and 28% were females. According to theIPI scoring the low, intermediate and high risk groups comprised of 28%, 28%, and 44%patients respectively. Of the 41 patients who received treatment, 58% achieved CR, 12%achieved PR and 24% had progressive disease respectively after frontline treatment withchemotherapy. In this study we found that the levels of CRP, IL4, IL6, IL10 and IFNgamma were significantly elevated in DLBCL patients as compared to the control group as shown in Table 1. The pretreatment serum level of CRP in DLBCL patients was significantly elevated in those with B symptoms and high risk IPI group as compared to those without B symptoms and low risk IPI respectively. It was also noted that IL2 showed a significant inverse correlation with stage and IPI of DLBCL patients. The median serum value of CRP was 30.5mg/l and 81mg/l in patients who achieved complete remission (CR) and those who did not achieve CR respectively after the frontline chemotherapy (p value - 0.007). The median serum level of IL6 was 31.5pg/ml and 14pg/ml respectively in those who achieved overall response (OR) and those who did not achieve. Thus OR was significantly lower in those patients with elevated IL6 (p value - 0.05).
Conclusion
Pro inflammatory markers can be used to predict treatment outcome in DLBCL patients. Our work concludes that there is alteration in cytokine profile of patients with DLBCL with inclination towards heightened Th2 response. CRP has shown a significant correlation with adverse disease characteristics and treatment response. It can emerge as a readily available and cost effective prognostic marker to predict treatment response in DLBCL patients especially in resource constraint settings.
Session topic: E-poster
Keyword(s): DLBCL
Abstract: PB1707
Type: Publication Only
Background
The currently available prognostic model for Diffuse Large B Cell Lymphoma (DLBCL) is not sufficient to predict the outcome of this heterogenous group of DLBCL. There is a need to find better prognostic markers for optimal risk stratification of DLBCL patients.
Aims
This study aimed to evaluate the prognostic significance of proinflammatory markers in pretreatment peripheral blood sample of patients of DLBCL.
Methods
We measured levels of CRP and Th1 and Th2 cytokines (IL2, IL4, IL6, IL10, IFN gammaand TNF alpha) in the pretreatment serum of 46 newly diagnosed DLBCL patients and in 10healthy controls. CRP was measured by nephelometry and cytokines were measured usingflowcytometric bead array assay. We compared the levels of these proinflammatory markers between cases and control groups. We evaluated the correlation of levels of these proinflammatory markers with disease characteristics like B symptoms, Ann Arbor stage, IPI and with treatment response.
Results
The median age of cases was 55 years (range 13-80 years) while that of controls was46 years. Among DLBCL patients 72% were males and 28% were females. According to theIPI scoring the low, intermediate and high risk groups comprised of 28%, 28%, and 44%patients respectively. Of the 41 patients who received treatment, 58% achieved CR, 12%achieved PR and 24% had progressive disease respectively after frontline treatment withchemotherapy. In this study we found that the levels of CRP, IL4, IL6, IL10 and IFNgamma were significantly elevated in DLBCL patients as compared to the control group as shown in Table 1. The pretreatment serum level of CRP in DLBCL patients was significantly elevated in those with B symptoms and high risk IPI group as compared to those without B symptoms and low risk IPI respectively. It was also noted that IL2 showed a significant inverse correlation with stage and IPI of DLBCL patients. The median serum value of CRP was 30.5mg/l and 81mg/l in patients who achieved complete remission (CR) and those who did not achieve CR respectively after the frontline chemotherapy (p value - 0.007). The median serum level of IL6 was 31.5pg/ml and 14pg/ml respectively in those who achieved overall response (OR) and those who did not achieve. Thus OR was significantly lower in those patients with elevated IL6 (p value - 0.05).
Conclusion
Pro inflammatory markers can be used to predict treatment outcome in DLBCL patients. Our work concludes that there is alteration in cytokine profile of patients with DLBCL with inclination towards heightened Th2 response. CRP has shown a significant correlation with adverse disease characteristics and treatment response. It can emerge as a readily available and cost effective prognostic marker to predict treatment response in DLBCL patients especially in resource constraint settings.
Session topic: E-poster
Keyword(s): DLBCL
Type: Publication Only
Background
The currently available prognostic model for Diffuse Large B Cell Lymphoma (DLBCL) is not sufficient to predict the outcome of this heterogenous group of DLBCL. There is a need to find better prognostic markers for optimal risk stratification of DLBCL patients.
Aims
This study aimed to evaluate the prognostic significance of proinflammatory markers in pretreatment peripheral blood sample of patients of DLBCL.
Methods
We measured levels of CRP and Th1 and Th2 cytokines (IL2, IL4, IL6, IL10, IFN gammaand TNF alpha) in the pretreatment serum of 46 newly diagnosed DLBCL patients and in 10healthy controls. CRP was measured by nephelometry and cytokines were measured usingflowcytometric bead array assay. We compared the levels of these proinflammatory markers between cases and control groups. We evaluated the correlation of levels of these proinflammatory markers with disease characteristics like B symptoms, Ann Arbor stage, IPI and with treatment response.
Results
The median age of cases was 55 years (range 13-80 years) while that of controls was46 years. Among DLBCL patients 72% were males and 28% were females. According to theIPI scoring the low, intermediate and high risk groups comprised of 28%, 28%, and 44%patients respectively. Of the 41 patients who received treatment, 58% achieved CR, 12%achieved PR and 24% had progressive disease respectively after frontline treatment withchemotherapy. In this study we found that the levels of CRP, IL4, IL6, IL10 and IFNgamma were significantly elevated in DLBCL patients as compared to the control group as shown in Table 1. The pretreatment serum level of CRP in DLBCL patients was significantly elevated in those with B symptoms and high risk IPI group as compared to those without B symptoms and low risk IPI respectively. It was also noted that IL2 showed a significant inverse correlation with stage and IPI of DLBCL patients. The median serum value of CRP was 30.5mg/l and 81mg/l in patients who achieved complete remission (CR) and those who did not achieve CR respectively after the frontline chemotherapy (p value - 0.007). The median serum level of IL6 was 31.5pg/ml and 14pg/ml respectively in those who achieved overall response (OR) and those who did not achieve. Thus OR was significantly lower in those patients with elevated IL6 (p value - 0.05).
Conclusion
Pro inflammatory markers can be used to predict treatment outcome in DLBCL patients. Our work concludes that there is alteration in cytokine profile of patients with DLBCL with inclination towards heightened Th2 response. CRP has shown a significant correlation with adverse disease characteristics and treatment response. It can emerge as a readily available and cost effective prognostic marker to predict treatment response in DLBCL patients especially in resource constraint settings.
Session topic: E-poster
Keyword(s): DLBCL
{{ help_message }}
{{filter}}