Hohloch Karin, Ziepert Marita, Truemper Lorenz, Buske Christian, Held Gerhard, Poeschel Viola, Chapuy Bjoern, Altmann Bettina
Department of Hematology and Oncology Kantonsspital Graubünden Chur Switzerland.
Department of Hematology and Oncology University Medical Center Georg-August University Göttingen Germany.
EJHaem. 2020 Jul 13;1(1):181-187. doi: 10.1002/jha2.61. eCollection 2020 Jul.
Serum albumin a well-known risk factor predicting outcome in many solid tumors. We explore the role of low serum albumin (≤3.5 g/dL) as an independent risk factor in elderly patients with aggressive B-cell lymphoma. Outcome of 429 patients treated with R-CHOP-14 in the RICOVER-60 trial and available serum albumin were analyzed in this retrospective study. Of the 429 patients in the RICOVER-60 trial, 137 (32%) had low and 292 (68%) had normal serum albumin levels (>3.5 g/dL). In the low albumin group, patients had significantly higher International Prognostic Index (IPI), bulky disease, extralymphatic involvement, and B-symptoms. Event-free survival (EFS) ( < .001), progression-free survival (PFS) ( < .001), and overall survival (OS) ( < .001) were significantly inferior for patients with low compared to those with normal serum albumin. Multivariate analysis adjusted for IPI shows following Hazard ratios (HR) for low serum albumin: EFS (HR = 1.5; 95% confidance interval [CI] [1.1; 2.1], = .009), PFS (HR = 1.7; 95% CI [1.2; 2.4], = .001) and OS (HR = 1.6; 95% CI [1.1; 2.3], = .006). Results were confirmed in 185 patients from the DENSE-R-CHOP-14 and SMARTE-R-CHOP-14 trials. In conclusion, low serum albumin is an independent risk factor in elderly patients with aggressive B-cell lymphoma treated with R-CHOP.
血清白蛋白是预测多种实体瘤预后的一个众所周知的风险因素。我们探讨低血清白蛋白（≤3.5 g/dL）作为老年侵袭性B细胞淋巴瘤独立风险因素的作用。在这项回顾性研究中，分析了RICOVER-60试验中接受R-CHOP-14治疗的429例患者的预后情况以及可用的血清白蛋白数据。在RICOVER-60试验的429例患者中，137例（32%）血清白蛋白水平低，292例（68%）血清白蛋白水平正常（>3.5 g/dL）。在低白蛋白组中，患者的国际预后指数（IPI）显著更高，有大包块病变、结外受累和B症状。与血清白蛋白水平正常的患者相比，血清白蛋白水平低的患者的无事件生存期（EFS）（<0.001）、无进展生存期（PFS）（<0.001）和总生存期（OS）（<0.001）明显更差。针对IPI进行调整的多变量分析显示，低血清白蛋白的风险比（HR）如下：EFS（HR = 1.5；95%置信区间[CI][1.1；2.1]，P = 0.009），PFS（HR = 1.7；95% CI[1.2；2.4]，P = 0.001）和OS（HR = 1.6；95% CI[1.1；2.3]，P = 0.006）。来自DENSE-R-CHOP-14和SMARTE-R-CHOP-14试验的185例患者也证实了这一结果。总之，低血清白蛋白是接受R-CHOP治疗的老年侵袭性B细胞淋巴瘤患者的一个独立风险因素。
