Journal article
Pretreatment Hemoglobin Adds Prognostic Information To The NCCN-IPI In Patients With Diffuse Large B-Cell Lymphoma Treated With Anthracycline-Containing Chemotherapy
Clinical epidemiology, Vol.11, pp.987-996
2019
DOI: 10.2147/CLEP.S219595
PMCID: PMC6861518
PMID: 31814771
Abstract
Hemoglobin (Hgb) concentration at diagnosis is associated with outcome in cancer. In a recently reported simplified 3-factor prognostic score in Hodgkin lymphoma, Hgb, along with age and clinical stage, outperformed the classical International Prognostic Score with seven parameters.
In the present study, we investigated if pretherapeutic Hgb concentration added prognostic information to the NCCN-IPI in diffuse large B-cell lymphoma. We included patients from the Danish Lymphoma Registry (LYFO; N = 3499) and from the Molecular Epidemiology Resource (MER; N = 1225), Mayo Clinic and University of Iowa. Four sex-specific Hgb groups were defined: below transfusion threshold, from transfusion threshold to below lower limit of normal, from lower limit of normal to the population mean, and above the mean. We used multivariable Cox regression to estimate the hazard rate ratios (HR) and 95% CIs for overall survival (OS) and event-free survival (EFS), adjusting for sex, NCCN-IPI, comorbidity, and rituximab treatment.
Approximately half of the patients had Hgb levels below the lower limit of normal. Compared to patients with Hgb levels above the mean, an inferior OS was directly correlated with lower pretreatment Hgb within the predefined groups (HR=1.23, HR=1.51, and HR=2.05, respectively). These findings were validated in the MER.
Based on multivariable analysis, lower pretreatment Hgb, even within the normal range but below the mean, added prognostic information to established indices such as the NCCN-IPI and the Charlson comorbidity index.
Details
- Title: Subtitle
- Pretreatment Hemoglobin Adds Prognostic Information To The NCCN-IPI In Patients With Diffuse Large B-Cell Lymphoma Treated With Anthracycline-Containing Chemotherapy
- Creators
- Michael R Clausen - Aarhus University HospitalMatthew J Maurer - Mayo ClinicSinna Pilgaard Ulrichsen - Aarhus University HospitalThomas S Larsen - Odense University HospitalBodil Himmelstrup - Zealand University HospitalDorthe Rønnov-Jessen - Vejle SygehusBrian K Link - University of IowaAndrew L Feldman - Mayo ClinicSusan L Slager - Mayo ClinicGrzegorz S Nowakowski - Mayo ClinicCarrie A Thompson - Dept of Medicine, Mayo Clinic, Rochester, MN, USAPer Trøllund Pedersen - Hospital South West JutlandJakob Madsen - Aalborg UniversityRobert S Pedersen - Regional Hospital HolstebroJette Sønderskov Gørløv - RigshospitaletJames R Cerhan - Mayo ClinicMette Nørgaard - Aarhus University HospitalFrancesco D'Amore - Aarhus University Hospital
- Resource Type
- Journal article
- Publication Details
- Clinical epidemiology, Vol.11, pp.987-996
- DOI
- 10.2147/CLEP.S219595
- PMID
- 31814771
- PMCID
- PMC6861518
- NLM abbreviation
- Clin Epidemiol
- ISSN
- 1179-1349
- eISSN
- 1179-1349
- Grant note
- U01 CA195568 / NCI NIH HHS P50 CA097274 / NCI NIH HHS
- Language
- English
- Date published
- 2019
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9984359595102771
Metrics
9 Record Views