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An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era

BACKGROUND: Systemic inflammatory parameters are associated with poor outcomes in malignant patients. Several inflammation-based cumulative prognostic score systems were established for various solid tumors. However, there is few inflammation based cumulative prognostic score system for patients wit...

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Autores principales: Sun, Feifei, Zhu, Jia, Lu, Suying, Zhen, Zijun, Wang, Juan, Huang, Junting, Ding, Zonghui, Zeng, Musheng, Sun, Xiaofei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749011/
https://www.ncbi.nlm.nih.gov/pubmed/29291712
http://dx.doi.org/10.1186/s12885-017-3931-z
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author Sun, Feifei
Zhu, Jia
Lu, Suying
Zhen, Zijun
Wang, Juan
Huang, Junting
Ding, Zonghui
Zeng, Musheng
Sun, Xiaofei
author_facet Sun, Feifei
Zhu, Jia
Lu, Suying
Zhen, Zijun
Wang, Juan
Huang, Junting
Ding, Zonghui
Zeng, Musheng
Sun, Xiaofei
author_sort Sun, Feifei
collection PubMed
description BACKGROUND: Systemic inflammatory parameters are associated with poor outcomes in malignant patients. Several inflammation-based cumulative prognostic score systems were established for various solid tumors. However, there is few inflammation based cumulative prognostic score system for patients with diffuse large B cell lymphoma (DLBCL). METHODS: We retrospectively reviewed 564 adult DLBCL patients who had received rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) therapy between Nov 1 2006 and Dec 30 2013 and assessed the prognostic significance of six systemic inflammatory parameters evaluated in previous studies by univariate and multivariate analysis:C-reactive protein(CRP), albumin levels, the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio(NLR), the platelet-lymphocyte ratio(PLR)and fibrinogen levels. RESULTS: Multivariate analysis identified CRP, albumin levels and the LMR are three independent prognostic parameters for overall survival (OS). Based on these three factors, we constructed a novel inflammation-based cumulative prognostic score (ICPS) system. Four risk groups were formed: group ICPS = 0, ICPS = 1, ICPS = 2 and ICPS = 3. Advanced multivariate analysis indicated that the ICPS model is a prognostic score system independent of International Prognostic Index (IPI) for both progression-free survival (PFS) (p < 0.001) and OS (p < 0.001). The 3-year OS for patients with ICPS =0, ICPS =1, ICPS =2 and ICPS =3 were 95.6, 88.2, 76.0 and 62.2%, respectively (p < 0.001). The 3-year PFS for patients with ICPS = 0–1, ICPS = 2 and ICPS = 3 were 84.8, 71.6 and 54.5%, respectively (p < 0.001). CONCLUSIONS: The prognostic value of the ICPS model indicated that the degree of systemic inflammatory status was associated with clinical outcomes of patients with DLBCL in rituximab era. The ICPS model was shown to classify risk groups more accurately than any single inflammatory prognostic parameters. These findings may be useful for identifying candidates for further inflammation-related mechanism research or novel anti-inflammation target therapies.
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spelling pubmed-57490112018-01-05 An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era Sun, Feifei Zhu, Jia Lu, Suying Zhen, Zijun Wang, Juan Huang, Junting Ding, Zonghui Zeng, Musheng Sun, Xiaofei BMC Cancer Research Article BACKGROUND: Systemic inflammatory parameters are associated with poor outcomes in malignant patients. Several inflammation-based cumulative prognostic score systems were established for various solid tumors. However, there is few inflammation based cumulative prognostic score system for patients with diffuse large B cell lymphoma (DLBCL). METHODS: We retrospectively reviewed 564 adult DLBCL patients who had received rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) therapy between Nov 1 2006 and Dec 30 2013 and assessed the prognostic significance of six systemic inflammatory parameters evaluated in previous studies by univariate and multivariate analysis:C-reactive protein(CRP), albumin levels, the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio(NLR), the platelet-lymphocyte ratio(PLR)and fibrinogen levels. RESULTS: Multivariate analysis identified CRP, albumin levels and the LMR are three independent prognostic parameters for overall survival (OS). Based on these three factors, we constructed a novel inflammation-based cumulative prognostic score (ICPS) system. Four risk groups were formed: group ICPS = 0, ICPS = 1, ICPS = 2 and ICPS = 3. Advanced multivariate analysis indicated that the ICPS model is a prognostic score system independent of International Prognostic Index (IPI) for both progression-free survival (PFS) (p < 0.001) and OS (p < 0.001). The 3-year OS for patients with ICPS =0, ICPS =1, ICPS =2 and ICPS =3 were 95.6, 88.2, 76.0 and 62.2%, respectively (p < 0.001). The 3-year PFS for patients with ICPS = 0–1, ICPS = 2 and ICPS = 3 were 84.8, 71.6 and 54.5%, respectively (p < 0.001). CONCLUSIONS: The prognostic value of the ICPS model indicated that the degree of systemic inflammatory status was associated with clinical outcomes of patients with DLBCL in rituximab era. The ICPS model was shown to classify risk groups more accurately than any single inflammatory prognostic parameters. These findings may be useful for identifying candidates for further inflammation-related mechanism research or novel anti-inflammation target therapies. BioMed Central 2018-01-02 /pmc/articles/PMC5749011/ /pubmed/29291712 http://dx.doi.org/10.1186/s12885-017-3931-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Sun, Feifei
Zhu, Jia
Lu, Suying
Zhen, Zijun
Wang, Juan
Huang, Junting
Ding, Zonghui
Zeng, Musheng
Sun, Xiaofei
An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era
title An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era
title_full An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era
title_fullStr An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era
title_full_unstemmed An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era
title_short An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era
title_sort inflammation-based cumulative prognostic score system in patients with diffuse large b cell lymphoma in rituximab era
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749011/
https://www.ncbi.nlm.nih.gov/pubmed/29291712
http://dx.doi.org/10.1186/s12885-017-3931-z
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