Baseline renal function as a prognostic indicator in patients with newly diagnosed diffuse large B-cell lymphoma
- Authors
- Hong, Junshik; Lee, Sojung; Chun, Gayoung; Jung, Ji Yong; Park, Jinny; Ahn, Jeong Yeal; Cho, Eun Kyung; Shin, Dong Bok; Lee, Jae Hoon
- Issue Date
- Jun-2016
- Publisher
- KOREAN SOC HEMATOLOGY
- Keywords
- Diffuse large B-cell lymphoma; Renal insufficiency; Prognosis; Rituximab
- Citation
- BLOOD RESEARCH, v.51, no.2, pp.113 - 121
- Journal Title
- BLOOD RESEARCH
- Volume
- 51
- Number
- 2
- Start Page
- 113
- End Page
- 121
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/8222
- DOI
- 10.5045/br.2016.51.2.113
- ISSN
- 2287-979X
- Abstract
- Background The association between baseline renal impairment (RI) and the prognosis of diffuse large B-cell lymphoma (DLBCL) was previously not defined. The aim of this study was to evaluate the prognostic value of RI in patients with DLBCL treated with three-weekly rituximab plus cyclophosphamide, Adriamycin, vincristine, and prednisolone immunochemotherapy (R-CHOP21). Methods Patients with newly diagnosed de novo DLBCLs treated with >= 1 cycle of R-CHOP21 were analyzed retrospectively. Pretreatment blood samples were collected and the glomerular filtration rate (GFR) was calculated. RI was defined by a GFR of < 60 mL/min/1.73 m(2) according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Results Of the 185 patients enrolled in the present study, 19 patients (10.3%) had RI. The reasons for baseline RI were pre-existing CKD (N=5), acute kidney injury due to either obstruction (N=2) or electrolyte imbalance (N=2) related to DLBCL, and undefined causes (N=10). Patients with baseline RI showed inferior overall survival (OS) compared to those without RI (P < 0.001). In multivariate analysis, RI was identified as an International Prognostic Index (IPI)-independent prognostic indicator. A baseline hemoglobin level of < 10 g/dL and the presence of RI effectively discriminated a portion of the patients with far inferior event-free survival and OS among the patients having high or high-intermediate risk cancers according to either the standard-or the National Comprehensive Cancer Network-IPI. Conclusion Pretreatment RI was an independent prognostic marker for inferior OS in patients with DLBCL treated with R-CHOP21 immunochemotherapy.
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