Contributions
Abstract: PB1787
Type: Publication Only
Background
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma, representing about 30% of cases. The introduction of rituximab (R) in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy, usually also known as ‘R-CHOP,’ improved survival outcomes, and has affected the importance of formerly recognized prognostic markers. In the pre-R era, the International Prognostic Index (IPI) was usually used to predict responses and prognoses in patients with high-risk non-Hodgkin’s lymphoma, but in the post-R era, the original IPI could not well identify a poor prognostic group with under half risk for survival.
Aims
We evaluated the clinical implication of the albumin to globulin ratio (AGR) in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone(R-CHOP).
Methods
Data for 232 DLBCL patients treated with first-line R-CHOP from 2004 to 2017 were reviewed retrospectively. Patients with AGR ≥1.22 and <1.22 were assigned to the high and low AGR groups, respectively. Treatment response and survival were compared according to AGR.
Results
The low AGR group (median overall survival [OS] = 26.87months; 95% confidence interval[CI]=4.19-49.55) showed a significant decrease in OS compared to the high AGR group (median OS=148.83months;95% CI=76.26-221.41;p<0.001). Progression-free survival (PFS) was also significantly decreased in the low AGR group (median PFS=14.29months; 95% CI=2.58-26.01) compared to the high AGR group (median PFS=148.83months; 95% CI=76.21-221.45; p<0.001). However, in a multivariate analysis, low AGR was an independent poor prognostic factor for OS (hazard ratio [HR]=0.55;95% CI=0.35-0.86;p=0.008) and PFS(HR=0.54;95% CI=0.35-0.83;p=0.005) only in elderly.
Conclusion
Pretreatment AGR can be useful for predicting clinical outcomes and prognosis in elderly patients with DLBCL treated with R-CHOP. Further large prospective studies will be necessary to validate our findings.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): DLBCL, prognosis
Abstract: PB1787
Type: Publication Only
Background
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma, representing about 30% of cases. The introduction of rituximab (R) in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy, usually also known as ‘R-CHOP,’ improved survival outcomes, and has affected the importance of formerly recognized prognostic markers. In the pre-R era, the International Prognostic Index (IPI) was usually used to predict responses and prognoses in patients with high-risk non-Hodgkin’s lymphoma, but in the post-R era, the original IPI could not well identify a poor prognostic group with under half risk for survival.
Aims
We evaluated the clinical implication of the albumin to globulin ratio (AGR) in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone(R-CHOP).
Methods
Data for 232 DLBCL patients treated with first-line R-CHOP from 2004 to 2017 were reviewed retrospectively. Patients with AGR ≥1.22 and <1.22 were assigned to the high and low AGR groups, respectively. Treatment response and survival were compared according to AGR.
Results
The low AGR group (median overall survival [OS] = 26.87months; 95% confidence interval[CI]=4.19-49.55) showed a significant decrease in OS compared to the high AGR group (median OS=148.83months;95% CI=76.26-221.41;p<0.001). Progression-free survival (PFS) was also significantly decreased in the low AGR group (median PFS=14.29months; 95% CI=2.58-26.01) compared to the high AGR group (median PFS=148.83months; 95% CI=76.21-221.45; p<0.001). However, in a multivariate analysis, low AGR was an independent poor prognostic factor for OS (hazard ratio [HR]=0.55;95% CI=0.35-0.86;p=0.008) and PFS(HR=0.54;95% CI=0.35-0.83;p=0.005) only in elderly.
Conclusion
Pretreatment AGR can be useful for predicting clinical outcomes and prognosis in elderly patients with DLBCL treated with R-CHOP. Further large prospective studies will be necessary to validate our findings.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): DLBCL, prognosis