Blood Res.  2019 Dec;54(4):244-252. 10.5045/br.2019.54.4.244.

Clinical impacts of inflammatory markers and clinical factors in patients with relapsed or refractory diffuse large B-cell lymphoma

Affiliations
  • 1Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Korea. hemon@pusan.ac.kr
  • 2Department of Hematology-Oncology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Korea.
  • 3Department of Hematology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 4Department of Hematology, Busan Haeundae Paik Hospital, Busan, Korea.
  • 5Department of Hematology, Dong-A University Hospital, Busan, Korea.

Abstract

BACKGROUND
Systemic inflammatory response can be associated with the prognosis of diffuse large B cell lymphoma (DLBCL). We investigated the systemic factors significantly related to clinical outcome in relapsed/refractory DLBCL.
METHODS
In 242 patients with DLBCL, several factors, including inflammatory markers were analyzed. We assessed for the correlation between the survivals [progression-free survival (PFS) and overall survival (OS)] and prognostic factors.
RESULTS
In these patients, a high derived neutrophil/lymphocyte ratio (dNLR) (PFS, HR=2.452, P=0.002; OS, HR=2.542, P=0.005), high Glasgow Prognostic Score (GPS) (PFS, HR=2.435, P=0.002; OS, HR=2.621, P=0.002), and high NCCN-IPI (PFS, HR=2.836, P=0.003; OS, HR=2.928, P=0.003) were significantly associated with survival in multivariate analysis. Moreover, we proposed a risk stratification model based on dNLR, GPS, and NCCN-IPI, thereby distributing patients into 4 risk groups. There were significant differences in survival among the 4 risk groups (PFS, P<0.001; OS, P<0.001).
CONCLUSION
In conclusion, dNLR, GPS, and NCCN-IPI appear to be excellent prognostic parameters for survival in relapsed/refractory DLBCL.

Keyword

Derived neutrophil/lymphocyte ratio; Glasgow prognostic score; DLBCL

MeSH Terms

B-Lymphocytes*
Humans
Lymphoma, B-Cell*
Multivariate Analysis
Prognosis

Figure

  • Fig. 1 Comparisons of the response rates and survivals among the salvage therapies administered to patients with relapsed diffuse large B cell lymphoma.

  • Fig. 2 Comparisons of the survival rates according to NCCN-IPI, glasgow prognostic score, and derived neutrophil/lymphocyte ratio in patients with relapsed diffuse large B cell lymphoma. Abbreviations: dNLR, derived neutrophil/lymphocyte ratio; GPS, glasgow prognostic score; NCCN-IPI, National Cancer Center Network-International Prognostic Index.

  • Fig. 3 Comparisons of survivals according to a combined scoring system based on NCCN-IPI, glasgow prognostic score, and derived neutrophil/lymphocyte ratio in patients with relapsed diffuse large B cell lymphoma.


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