القيمة الانذارية لكل من فيرتين المصل المصل والمشعر العالمي للإنذار ا

Authors

  • Feras Housin Tishreen University

Abstract

Abstract

Background

The International Prognostic Index (IPI) is a the better predictor of outcome in diffuse  large B cell lymphoma patients and remains widely used today,  many studies have   shown a correlation between high baseline serum ferritin concentrations ,high pre-treatment  serum LDH and poor prognosis in many malignancies, which prompted us to study the prognostic value of  pre-treatment serum ferritin, pre-treatment  serum LDH and IPI in patients with DLBCL.                                                                                             

            Aim of study

Studying the effect of pre-treatment serum ferritin, pre-treatment serum LDH and IPI on overall survival (OS) and progression-free survival (PFS) for 24 months in patients with DLBCL.                                                                                                    

Patients and methods:

A prospective study on 25 patients aged over 18 years with (DLBCL) newly diagnosed in the chemotherapy department at Tishreen University Hospital in Lattakia-Syria during 2015-2016.Patients were subjected to routine hematological and biochemical examinations and undergoing chemotherapy according to R-CHOP protocol. Baseline ferritin concentrations, LDH and IPI were assayed. We assessed the prognostic value of pre-treatment serum ferritin, pre-treatment serum LDH and IPI in patients with DLBCL through a study of overall survival (OS), progression-free survival (PFS), and mortality rate for 24 months. patients were divided into three groups according to baseline ferritin (ferritin less than 100 ng / ml – ferritin 100-200 ng/ml-ferritin greater than 200 ng/ml). Patients were divided into three groups according to baseline serum LDH (LDH less than 480 IU– LDH 480-860 IU-LDH greater than 860 IU). Patients were divided into two groups according to baseline IPI (low/low-moderate risk cases (IPI 0-1) and high-moderate / high risk cases (IPI 2-4).                                                                       

 Results

The sample included 25 patients (17 males, 8 females), average age of 55 years. The mean serum ferritin was (366.2 ± 573.6) ng / ml. The average, overall survival (OS) and progression free survival (PFS) were respectively (18.5 ± 8.4) and (14.6 ± 8.4) months.  The OS, PFS rate for 24 months were respectively 68%, and 36 %. An elevation of pre-treatment serum ferritin was accompanied by a bad prognosis at a severity rate of three times. The mean, OS and PFS were respectively (12.7 ± 9.4) months and (9.3 ± 7.9) months in patients with serum ferritin greater than 200 ng / ml compared to (24 ± 0) months and (22.2 ± 3.7) months respectively in patients with serum ferritin less than 100 ng/ ml, (p-value = 0.01). The mean, OS and PFS were respectively (16±10.9) months and (6.9±5.1) months in patients with serum LDH greater than 860 IU compared to (20.7±6.9) months and (19.3±7.1) months respectively in patients with serum LDH less than 480 IU, (p-value = 0.01). The mean, OS and PFS were respectively (14.2±9.2) months and (9.5±6.7) months in patients with IPI high - moderate / high (IPI 2-4) compared to (24±0) months and (21.07±5.3) months respectively in patients with IPI (low/low-moderate risk  (IPI 0-1) (p-value = 0.002). The prognostic value of serum ferritin is the same as the prognostic value of LDH for each OS and PFS in patients with DLBCL. While IPI was the most pronostic factor correlated with OS, PFS patients with DLBCL, where high - moderate / high-risk cases (IPI 2-4) were associated with a very poor prognosis disease. Death occurred in 32% of  total study sample,  the relationship between the pretreatment  values ​​of serum ferritin , serum LDH and IPI and the incidence of death was studied,  it was found that there were statistically significant differences, noting that Both the basal ferritin concentration and the basal serum LDH are associated with the incidence of mortality, as ferritin is more closely related to the serum LDH (p-value, 0.01 vs 0.02), whereas IPI is most closely related to the occurrence of mortality (p-value = 0.001).                                                                                                          

Conclusions

High pre-treatment serum ferritin concentrations more than 200 ng / ml, high pre-treatment serum LDH and IPI (2-4) can be an important independent indicator for poor prognosis in patients with DLBCL. While IPI was the most correlated with staging disease and occurrence of mortality in in patients with DLBCL.                                                           

Key words

Diffuse large B cell lymphoma, serum ferritin, serum LDH, IPI and prognostic value.

Author Biography

Feras Housin, Tishreen University

Associate Professor in clinical Hematology, Head of Internal Medicine Department, Head of Clinical Hematology Department

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Published

2022-06-16

How to Cite

1.
حسين ف. القيمة الانذارية لكل من فيرتين المصل المصل والمشعر العالمي للإنذار ا. Tuj-hlth [Internet]. 2022Jun.16 [cited 2024Apr.28];44(2):19-36. Available from: https://journal.tishreen.edu.sy/index.php/hlthscnc/article/view/11734

Issue

Vol. 44 No. 2 (2022): Tishreen University Journal for Research and Scientific Studies - Health Sciences Series

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