Contributions
Abstract: PB2069
Type: Publication Only
Background
It is known, that extracellular ferritin takes part in mechanisms of neoplasm progression in solid cancer, and can stimulate proliferation of malignant cells lines. Similarly, the ferritin serum level correlates with tumor mass volume and tumor activity in patients with hematological malignancies, such as malignant lymphoma and acute leukemia. On the other hand, the normalization of ferritin serum level in remission has proved the clinical value of ferritin for initial assessment and therapy response evaluation, especially in patients with malignant lymphomas.
Aims
Was to evaluate the increasing ferritin serum level in newly diagnosed patients with malignant lymphomas.
Methods
A total of 98 patients with malignant lymphoma, including 72 patients with non-Hodgkin’s lymphoma (73,5%) and 26 patients with Hodgkin’s lymphoma have been examined in our study. 84,7% of the patients with non-Hodgkin’s lymphomas have advanced staged of disease (III-IV). All patients have received 4-6 courses of chemotherapy. The ferritin serum level was detected by Enzyme-linked Immunosorbent Assay (ELISA).
Results
the overall survival was evaluated in two groups of newly diagnosed patients: in first group of patients (n=43) the ferritin serum level was ˂350ng/ml, in another group of patients (n=55) the ferritin serum level was >350 ng/ml.
The median survival in patients with ferritin level >350ng/ml was lower (40 months; p=0,004) than in patients with normal level of ferritin at onset of disease - in this group of patients the median survival has not been reached.
The initial level of hemoglobin at the onset of disease was used as the reference marker of poor prognosis. The overall survival (OS) in the group of patients with normal level of hemoglobin (>120g/L) has not reached the median of survival, whereas patients with anemia (hemoglobin ˂120 g/L) has tended to deteriorate the overall survival (OS) - the median of survival was 40 months (p=0,007). Besides that, the low level of hemoglobin, correlates with significant increasing the mortality risk (Odds ratio (OR)-6,333; confidence interval (CI) – 95%; 2,152-18,638; p˂0,05). Patients with high ferritin serum level at the onset of disease also has poorer results of survival and higher risk of mortality (OR 8,122; CI-95%, 1,764-37,396; p˂0,05) by comparison with the group of newly diagnosed patients with ferritin serum level ˂350ng/ml.
Conclusion
These findings allow to conclude the patients with hyperferritinemia at the onset of disease in the group of patients with poor prognosis and lower overall survival. The high ferritin serum level in patients without prior blood transfusion should consider as a significant marker of poor prognosis. The analysis of ferrokinetics in patients with lymphomas before starting the chemotherapy make it possible to use preventive approach for combining groups with poor prognosis and elimination of negative factors.
Session topic: 30. Iron metabolism, deficiency and overload
Keyword(s): Ferritin, Iron Metabolism, Malignant lymphoma
Abstract: PB2069
Type: Publication Only
Background
It is known, that extracellular ferritin takes part in mechanisms of neoplasm progression in solid cancer, and can stimulate proliferation of malignant cells lines. Similarly, the ferritin serum level correlates with tumor mass volume and tumor activity in patients with hematological malignancies, such as malignant lymphoma and acute leukemia. On the other hand, the normalization of ferritin serum level in remission has proved the clinical value of ferritin for initial assessment and therapy response evaluation, especially in patients with malignant lymphomas.
Aims
Was to evaluate the increasing ferritin serum level in newly diagnosed patients with malignant lymphomas.
Methods
A total of 98 patients with malignant lymphoma, including 72 patients with non-Hodgkin’s lymphoma (73,5%) and 26 patients with Hodgkin’s lymphoma have been examined in our study. 84,7% of the patients with non-Hodgkin’s lymphomas have advanced staged of disease (III-IV). All patients have received 4-6 courses of chemotherapy. The ferritin serum level was detected by Enzyme-linked Immunosorbent Assay (ELISA).
Results
the overall survival was evaluated in two groups of newly diagnosed patients: in first group of patients (n=43) the ferritin serum level was ˂350ng/ml, in another group of patients (n=55) the ferritin serum level was >350 ng/ml.
The median survival in patients with ferritin level >350ng/ml was lower (40 months; p=0,004) than in patients with normal level of ferritin at onset of disease - in this group of patients the median survival has not been reached.
The initial level of hemoglobin at the onset of disease was used as the reference marker of poor prognosis. The overall survival (OS) in the group of patients with normal level of hemoglobin (>120g/L) has not reached the median of survival, whereas patients with anemia (hemoglobin ˂120 g/L) has tended to deteriorate the overall survival (OS) - the median of survival was 40 months (p=0,007). Besides that, the low level of hemoglobin, correlates with significant increasing the mortality risk (Odds ratio (OR)-6,333; confidence interval (CI) – 95%; 2,152-18,638; p˂0,05). Patients with high ferritin serum level at the onset of disease also has poorer results of survival and higher risk of mortality (OR 8,122; CI-95%, 1,764-37,396; p˂0,05) by comparison with the group of newly diagnosed patients with ferritin serum level ˂350ng/ml.
Conclusion
These findings allow to conclude the patients with hyperferritinemia at the onset of disease in the group of patients with poor prognosis and lower overall survival. The high ferritin serum level in patients without prior blood transfusion should consider as a significant marker of poor prognosis. The analysis of ferrokinetics in patients with lymphomas before starting the chemotherapy make it possible to use preventive approach for combining groups with poor prognosis and elimination of negative factors.
Session topic: 30. Iron metabolism, deficiency and overload
Keyword(s): Ferritin, Iron Metabolism, Malignant lymphoma