Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Prochazka, KT; Melchardt, T; Posch, F; Schlick, K; Deutsch, A; Beham-Schmid, C; Weiss, L; Gary, T; Neureiter, D; Klieser, E; Greil, R; Neumeister, P; Egle, A; Pichler, M.
NCCN-IPI score-independent prognostic potential of pretreatment uric acid levels for clinical outcome of diffuse large B-cell lymphoma patients.
Br J Cancer. 2016; 115(10):1264-1272
Doi: 10.1038/bjc.2016.325
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- Führende Autor*innen der Med Uni Graz
- Pichler Martin
- Prochazka Katharina
- Co-Autor*innen der Med Uni Graz
- Beham-Schmid Christine
- Deutsch Alexander
- Gary Thomas
- Neumeister Peter
- Posch Florian
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- Abstract:
- Blood-based parameters are gaining increasing interest as potential prognostic biomarkers in patients with diffuse large B-cell lymphoma (DLBCL). The aim of this study was to comprehensively evaluate the prognostic significance of pretreatment plasma uric acid levels in patients with newly diagnosed DLBCL. The clinical course of 539 DLBCL patients, diagnosed and treated between 2004 and 2013 at two Austrian high-volume centres with rituximab-based immunochemotherapy was evaluated retrospectively. The prognostic influence of uric acid on overall survival (OS) and progression-free survival (PFS) were studied including multi-state modelling, and analysis of conditional survival. Five-year OS and PFS were 50.4% (95% CI: 39.2-60.6) and 44.0% (33.4-54.0) in patients with uric acid levels above the 75th percentile of the uric acid distribution (Q3, cut-off: 6.8 mg dl-1), and 66.2% (60.4-71.5) and 59.6% (53.7-65.0%) in patients with lower levels (log-rank P=0.002 and P=0.0045, respectively). In univariable time-to-event analysis, elevated uric acid levels were associated with a worse PFS (hazard ratio (HR) per 1 log increase in uric acid 1.47, 95% CI: 1.10-1.97, P=0.009) and a worse OS (HR=1.60, 95% CI: 1.16-2.19, P=0.004). These associations prevailed upon multivariable adjustment for the NCCN-IPI score. Uric acid levels significantly improved the predictive performance of the R-IPI and NCCN-IPI scores, and in multi-state analysis, it emerged as a highly significant predictor of an increased risk of death without developing recurrence (transition-HR=4.47, 95% CI: 2.17-9.23, P<0.0001). We demonstrate that elevated uric acid levels predict poor long-term outcomes in DLBCL patients beyond the NCCN-IPI risk index.
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- Adult -
- Aged -
- Antineoplastic Agents - therapeutic use
- Austria -
- Biomarkers, Tumor - blood
- Disease-Free Survival -
- Female -
- Humans -
- Immunotherapy - methods
- Kaplan-Meier Estimate -
- Lymphoma, Large B-Cell, Diffuse - blood
- Lymphoma, Large B-Cell, Diffuse - drug therapy
- Lymphoma, Large B-Cell, Diffuse - pathology
- Male -
- Middle Aged -
- Neoplasm Recurrence, Local - drug therapy
- Neoplasm Recurrence, Local - pathology
- Prognosis -
- Proportional Hazards Models -
- Retrospective Studies -
- Rituximab - therapeutic use
- Uric Acid - blood
- Find related publications in this database (Keywords)
- prognosis
- DLBCL
- uric acid