Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.
Leuk Lymphoma. 2021 Feb;62(2):291-299. doi: 10.1080/10428194.2020.1832673. Epub 2020 Oct 16.
Diffuse large B-cell lymphoma (DLBCL) is the most frequent type of lymphoma. Our retrospective study included 553 newly diagnosed DLBCL patients from May 2009 to October 2019. The relationships between hypogammaglobulinemia, hypocomplementemia and progression-free survival (PFS) and overall survival (OS) were assessed. In our center, 19.0% of patients had hypogammaglobulinemia, and 7.7% had hypocomplementemia at diagnosis. Immunoglobulin and complement deficiencies were associated with advanced disease and displayed inferior PFS and OS. Then, we designed a new immunization cumulative prognostic score (ICPS) model to comprehensively clarify the effect of these two variables on prognosis. Multivariate analysis showed that ICPS was an independent prognostic indicator for inferior clinical outcomes (PFS: = 0.007, OS: = 0.003). Furthermore, the predictive effect of ICPS combined with the International Prognostic Index (IPI) was superior to that of IPI alone (PFS: = 0.016, OS: = 0.037). In conclusion, hypogammaglobulinemia and hypocomplementemia could be regarded as adverse prognostic indicators in DLBCL.
弥漫性大 B 细胞淋巴瘤 (DLBCL) 是最常见的淋巴瘤类型。我们的回顾性研究纳入了 2009 年 5 月至 2019 年 10 月期间新诊断的 553 例 DLBCL 患者。评估了低丙种球蛋白血症、低补体血症与无进展生存期 (PFS) 和总生存期 (OS) 的关系。在我们中心，19.0%的患者在诊断时存在低丙种球蛋白血症，7.7%的患者存在低补体血症。免疫球蛋白和补体缺乏与疾病的晚期有关，并显示出较差的 PFS 和 OS。然后，我们设计了一种新的免疫接种累积预后评分 (ICPS) 模型，以全面阐明这两个变量对预后的影响。多变量分析表明，ICPS 是临床结局较差的独立预后指标（PFS：=0.007，OS：=0.003）。此外，ICPS 与国际预后指数 (IPI) 联合的预测效果优于 IPI 单独的预测效果（PFS：=0.016，OS：=0.037）。总之，低丙种球蛋白血症和低补体血症可视为 DLBCL 的不良预后指标。
