Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
Clin Lymphoma Myeloma Leuk. 2014 Feb;14(1):43-9. doi: 10.1016/j.clml.2013.09.008. Epub 2013 Oct 1.
Elevated levels of serum ferritin have been documented to be an adverse prognostic factor in patients with hematologic malignancies undergoing hematopoietic stem cell transplantation. The purpose of this study was to estimate the correlation between elevated levels of serum ferritin and survival outcomes in patients with non-Hodgkin lymphoma (NHL).
A total of 267 patients who were newly diagnosed with NHL and who received chemotherapy between September 1999 and April 2012 were retrospectively analyzed.
In multivariate analysis, other chemotherapy regimens excluding CHOP-like chemotherapy regimens (cyclophosphamide, adriamycin, vincristine, prednisolone) and RCHOP (rituximab plus CHOP), a high level of β2-microglobulin, a high-intermediate/high risk according to the international prognostic index (IPI), and elevated levels of serum ferritin were all significant independent prognostic factors for 5-year progression-free survival rates. RCHOP and other chemotherapy regimens, a high level of β2-microglobulin, a high-intermediate/high IPI risk, and high levels of serum ferritin were significant independent prognostic factors for 5-year overall survival rates.
Elevated levels of serum ferritin of 500 ng/mL or more as well as the use of chemotherapy regimens besides CHOP-like or RCHOP, a high-intermediate/high risk IPI, and a high level of beta2-microglobulin in NHL may be an important marker for predicting poor survival outcomes.
有研究记录显示，血清铁蛋白水平升高是接受造血干细胞移植的血液恶性肿瘤患者的不良预后因素。本研究旨在评估血清铁蛋白水平升高与非霍奇金淋巴瘤（NHL）患者生存结局的相关性。
回顾性分析了 1999 年 9 月至 2012 年 4 月期间新诊断为 NHL 并接受化疗的 267 例患者。
多因素分析显示，除 CHOP 样化疗方案（环磷酰胺、阿霉素、长春新碱、泼尼松）和 RCHOP（利妥昔单抗联合 CHOP）以外的其他化疗方案、高水平β2-微球蛋白、国际预后指数（IPI）中高危/极高危以及血清铁蛋白升高均为 5 年无进展生存率的独立预后因素。RCHOP 和其他化疗方案、高水平β2-微球蛋白、中高危/极高危 IPI 和高水平血清铁蛋白是 5 年总生存率的独立预后因素。
血清铁蛋白水平升高（≥500ng/ml）、除 CHOP 样或 RCHOP 以外的化疗方案、中高危/极高危 IPI 以及β2-微球蛋白水平升高可能是非霍奇金淋巴瘤患者预后不良的重要标志物。
