Kim Seok-Hyun, Go Se-Il, Seo Jangho, Kang Myoung Hee, Park Sung Woo, Kim Hoon-Gu, Lee Gyeong-Won
Division of Hematology and Medical Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
Leuk Res. 2018 Aug;71:100-105. doi: 10.1016/j.leukres.2018.07.014. Epub 2018 Jul 18.
We evaluated the clinical implications of the albumin to globulin ratio (AGR) in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP).
Data of 232 patients with DLBCL treated with first-line R-CHOP from 2004 to 2017 were reviewed retrospectively. Patients with AGR values ≥1.22 and <1.22 were assigned to the high and low AGR groups, respectively. Treatment response, treatment-related toxicity, and survival were compared according to the AGR.
The complete response rate was significantly lower in the low AGR group than in the high AGR group (59.1% vs. 81.3%; p < 0.001). Treatment-related mortality was also more frequent in the low AGR group than in the high AGR group (14.0% vs. 4.3%; p = 0.009). The low AGR group (median overall survival [OS] = 26.87 months; 95% confidence interval [CI] = 4.19-49.55) showed a significant decrease in OS compared to the high AGR group (median OS = 148.83 months; 95% CI = 76.26-221.41; p < 0.001). Progression-free survival (PFS) also decreased significantly in the low AGR group (median PFS = 14.29 months; 95% CI = 2.58-26.01) compared to the high AGR group (median PFS = 148.83 months; 95% CI = 76.21-221.45; p < 0.001). In a multivariate analysis, low AGR was an independent poor prognostic factor for OS and PFS.
Pretreatment AGR was useful for predicting treatment response, treatment-related toxicity, and prognosis in patients with DLBCL treated with R-CHOP. Further large prospective studies will be necessary to validate our findings.
我们评估了白蛋白与球蛋白比值（AGR）在接受利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松（R-CHOP）治疗的弥漫性大B细胞淋巴瘤（DLBCL）患者中的临床意义。
回顾性分析了2004年至2017年接受一线R-CHOP治疗的232例DLBCL患者的数据。AGR值≥1.22和<1.22的患者分别被分配到高AGR组和低AGR组。根据AGR比较治疗反应、治疗相关毒性和生存率。
低AGR组的完全缓解率显著低于高AGR组（59.1%对81.3%；p<0.001）。低AGR组的治疗相关死亡率也高于高AGR组（14.0%对4.3%；p = 0.009）。低AGR组（中位总生存期[OS]=26.87个月；95%置信区间[CI]=4.19-49.55）与高AGR组（中位OS = 148.83个月；95%CI = 76.26-221.41；p<0.001）相比，OS显著降低。与高AGR组（中位无进展生存期[PFS]=148.83个月；95%CI = 76.21-221.45；p<0.001）相比，低AGR组的无进展生存期（PFS）也显著降低（中位PFS = 14.29个月；95%CI = 2.58-26.01）。在多变量分析中，低AGR是OS和PFS的独立不良预后因素。
治疗前AGR有助于预测接受R-CHOP治疗的DLBCL患者的治疗反应、治疗相关毒性和预后。需要进一步的大型前瞻性研究来验证我们的发现。
