Prognostic Value Of Serum Albumin Level In Patients With Diffuse Large B Cell Lymphoma

Object To investigate the value of serum albumin level before chemotherapy in patients with diffuse large B cell lymphoma receiving chemotherapy.Methods A retrospective analysis of 127 patients with DLBCL treated in the Fujian Medical University Union Hospital from January 1st,2010 to December 31 st,2014.The gender,age,Ann Arbor stage,ECOG score,laboratory examination,treatment protocol,international prognostic index,remission rate,overall survival time,and disease-free survival time were analyzed.The optimal threshold value of serum albumin was obtained by ROC curve analysis.Univariate and multivariate survival analysis to analyze the factors affecting the overall survival time of DLBCL patients.Kaplan-Meier method to draw the survival function curve.Result In this study 127 patients,including 71 cases of male(55.9%),56 cases of female(44.1%),male: female =1.3:1;the median age was 56 years old(18-86);clinical characteristics: ECOG more than one score 22 cases(17.3%),45 cases(35.4%)with B symptoms,LDH increased in 67 cases(52.8%),SA within 34g/L 70 cases(55.1%),extranodal involvement in 69 cases(54.3%),32 cases(25.2%)of bone marrow involvement,germinal center B cell like in 45 cases(35.4%),non germinal center B cell like in 81 cases(63.8%),Ann Arbor I-II in 41 patients(32.3%),Ann Arbor III-IV in 86 patients(67.7%).Median follow-up was 25(0-66)months,the median OS was not reached,the median PFS was 21 months,one year’s,three years’ and five years’ OS were 70.3%,61%,50.5%;one year’s,three years’ and five years’ PFS were 56.7%,41.2%,32%.Univariate analysis showed that the SA no more than 34g/L,the increase of LDH,Ann Arbor III-IV,with B symptoms,ECOG more than one score,bone marrow involvement suggesting that DLBCL patients with poor prognosis;gender,age,pathological type has little effect on the prognosis of DLBCL patients.Long term efficacy analysis showed that the OS of the R-CHOP group was better than that of the CHOP group,the difference was statistically significant(P=0.003).Kaplan-Meier analysis of the changes,the first time and second times before treatment showed that SA for >34 g/L patients in the group compared with SA for less than or equal to 34 patients in the g/L group had a longer OS,the difference was statistically significant(P=0.020);with the same first SA level,change of second time SA without statistical significance,can not say that there is OS difference in changes of the second time SA.IPI/aa IPI can be used to assess risk stratification(P=0.003)in patients with DLBCL,and NCCN-IPI may also be used to assess risk stratification(P=0.000)in patients with DLBCL.Multivariate analysis showed that SA≤34g/L was independent prognostic factor in DLBCL patients(HR=0.48,95%CI=0.26-0.90,P=0.022);R-CHOP sample treatment was also the independent prognostic factor in DLBCL patients(HR=0.43,95%CI=0.24-0.76,P=0.004).Conclusion This study shows that serum albumin before chemotherapy can be used as the evaluation of the prognosis of patients with DLBCL,serum albumin was lower than 34g/L indicates a poor prognosis.Low SA before chemotherapy showed lower OS,which was not affected by the level of SA before the second chemotherapy.