Contributions
Abstract: PB1789
Type: Publication Only
Background
Diffuse large B-cell lymphoma (DLBCL) is an aggressive form of Non-Hodgkin’s lymphoma (NHL) which can occur de novo or by transformation of a less aggressive NHL of B-cell origin such as follicular lymphoma (FL). The genesis of lymphoma has yet to be explained. Several studies have suggested that oxidative stress, via chronic inflammation, might play a role in DLBCL, since its involvement has been shown in aging and in many hematological disorders1-8.
Aims
The major aim of this study is to evaluate the levels of reactive oxygen species and the total antioxidant capacity in patients with DLBCL compared to healthy controls before and after R-CHOP therapy. The minor aim is to observe if the level of HDL-cholesterol was related to the oxidative status of the study group.
Methods
We enrolled 32 Romanian patients with DLBCL and 20 healthy controls. Informed consent was obtained from all subjects involved. The positive diagnosis was based on lymph node biopsy with histopathological and immunohistochemical examination. The Ann-Arbor staging system was used for staging. The standard treatment consisted of 6-8 cycles of R-CHOP. Oxidative stress was evaluated at diagnosis and at the end of therapy using a CR3000 analyzer from a single drop of capillary blood. Reactive oxygen species were evaluated by FORT (Free Oxygen Radicals Testing) and the total antioxidant capacity by the FORD (Free Oxygen Radicals Defense) assays. The normal ranges for the assays are: FORT < 2.3 mmol/L H2O2 and FORD = 1.07 – 1.53 mmol/L. HDL-cholesterol was also evaluated. Statistical data analysis was performed using the student T-test and a p-value ≤ 0.05 was considered significant.
Results
The study group had the following characteristics: median age = 52.0 years, 62.5% males, 37.5% females, 75% patients from urban areas, 25% patients from rural areas, 93.75% de novo DLBCL cases, 6.25% cases transformed from FL. The control group had a median age = 64.1 ± 2.26 years. DLBCL staging revealed: stage IIB = 5 cases, stage IIIB = 19 cases and stage IVB = 8 cases. The evolution was favorable with complete remission in 24 cases, 6 patients had partial remission after conventional treatment, and 2 patients had refractory disease. Before treatment, HDL-cholesterol value was normal (> 60 mg/dL) in 9 patients (5 in stage IIB and 4 stage IIIB) and low in 23 patients. The results of oxidative status evaluation and HDL-cholesterol are depicted as mean values in the attached table. After treatment, FORD and HDL-cholesterol values significantly increased, whereas FORT values significantly decreased (p ≤ 0.05), with the exception of the 2 cases of refractory DLBCL.
Conclusion
We found an unbalanced oxidative status in DLBCL patients compared to controls: FORT levels were increased, whereas FORD and HDL-cholesterol levels were decreased. FORT levels decreased, whereas FORD and HDL-cholesterol values increased after chemotherapy regimens. Further comprehensive studies must be performed to highlight the involvement of oxidative stress in DLBCL.
References: 1. Gaman AM. Rom J Morphol Embryol. 2013;54(1):71-6. 2. Gaman AM, et al. Rom J Morphol Embryol. 2011;52(2):719-22. 3. Gaman AM, et al. Haematologica. 2014; 99(s1):773. abstract n. PB2030. 4. Gaman MA, et al. Haematologica. 2017; 102(s2):840. abstract n. PB2119. 5. Gaman AM, et al. Aging Dis. 2016 May 27;7(3):307-17. doi: 10.14336/AD.2015.1022. 6. Gaman AM, et al. Oxid Med Cell Longev. 2014;2014:158135. doi: 10.1155/2014/158135. 7. Gaman AM, et al. Haematologica. 2015; 100(s1):772. abstract n. PB1967. 8. Gaman MA, et al. Haematologica. 2017; 102(s2):835. abstract n. PB2105.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Antioxidants, Follicular lymphoma, Non-Hodgkin's lymphoma, Reactive oxygen species
Abstract: PB1789
Type: Publication Only
Background
Diffuse large B-cell lymphoma (DLBCL) is an aggressive form of Non-Hodgkin’s lymphoma (NHL) which can occur de novo or by transformation of a less aggressive NHL of B-cell origin such as follicular lymphoma (FL). The genesis of lymphoma has yet to be explained. Several studies have suggested that oxidative stress, via chronic inflammation, might play a role in DLBCL, since its involvement has been shown in aging and in many hematological disorders1-8.
Aims
The major aim of this study is to evaluate the levels of reactive oxygen species and the total antioxidant capacity in patients with DLBCL compared to healthy controls before and after R-CHOP therapy. The minor aim is to observe if the level of HDL-cholesterol was related to the oxidative status of the study group.
Methods
We enrolled 32 Romanian patients with DLBCL and 20 healthy controls. Informed consent was obtained from all subjects involved. The positive diagnosis was based on lymph node biopsy with histopathological and immunohistochemical examination. The Ann-Arbor staging system was used for staging. The standard treatment consisted of 6-8 cycles of R-CHOP. Oxidative stress was evaluated at diagnosis and at the end of therapy using a CR3000 analyzer from a single drop of capillary blood. Reactive oxygen species were evaluated by FORT (Free Oxygen Radicals Testing) and the total antioxidant capacity by the FORD (Free Oxygen Radicals Defense) assays. The normal ranges for the assays are: FORT < 2.3 mmol/L H2O2 and FORD = 1.07 – 1.53 mmol/L. HDL-cholesterol was also evaluated. Statistical data analysis was performed using the student T-test and a p-value ≤ 0.05 was considered significant.
Results
The study group had the following characteristics: median age = 52.0 years, 62.5% males, 37.5% females, 75% patients from urban areas, 25% patients from rural areas, 93.75% de novo DLBCL cases, 6.25% cases transformed from FL. The control group had a median age = 64.1 ± 2.26 years. DLBCL staging revealed: stage IIB = 5 cases, stage IIIB = 19 cases and stage IVB = 8 cases. The evolution was favorable with complete remission in 24 cases, 6 patients had partial remission after conventional treatment, and 2 patients had refractory disease. Before treatment, HDL-cholesterol value was normal (> 60 mg/dL) in 9 patients (5 in stage IIB and 4 stage IIIB) and low in 23 patients. The results of oxidative status evaluation and HDL-cholesterol are depicted as mean values in the attached table. After treatment, FORD and HDL-cholesterol values significantly increased, whereas FORT values significantly decreased (p ≤ 0.05), with the exception of the 2 cases of refractory DLBCL.
Conclusion
We found an unbalanced oxidative status in DLBCL patients compared to controls: FORT levels were increased, whereas FORD and HDL-cholesterol levels were decreased. FORT levels decreased, whereas FORD and HDL-cholesterol values increased after chemotherapy regimens. Further comprehensive studies must be performed to highlight the involvement of oxidative stress in DLBCL.
References: 1. Gaman AM. Rom J Morphol Embryol. 2013;54(1):71-6. 2. Gaman AM, et al. Rom J Morphol Embryol. 2011;52(2):719-22. 3. Gaman AM, et al. Haematologica. 2014; 99(s1):773. abstract n. PB2030. 4. Gaman MA, et al. Haematologica. 2017; 102(s2):840. abstract n. PB2119. 5. Gaman AM, et al. Aging Dis. 2016 May 27;7(3):307-17. doi: 10.14336/AD.2015.1022. 6. Gaman AM, et al. Oxid Med Cell Longev. 2014;2014:158135. doi: 10.1155/2014/158135. 7. Gaman AM, et al. Haematologica. 2015; 100(s1):772. abstract n. PB1967. 8. Gaman MA, et al. Haematologica. 2017; 102(s2):835. abstract n. PB2105.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Antioxidants, Follicular lymphoma, Non-Hodgkin's lymphoma, Reactive oxygen species