القيمة الانذارية لكل من فيرتين المصل المصل والمشعر العالمي للإنذار ا
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.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The authors retain the copyright and grant the right to publish in the magazine for the first time with the transfer of the commercial right to Tishreen University Journal for Research and Scientific Studies - Health Sciences Series
Under a CC BY- NC-SA 04 license that allows others to share the work with of the work's authorship and initial publication in this journal. Authors can use a copy of their articles in their scientific activity, and on their scientific websites, provided that the place of publication is indicted in Tishreen University Journal for Research and Scientific Studies - Health Sciences Series . The Readers have the right to send, print and subscribe to the initial version of the article, and the title of Tishreen University Journal for Research and Scientific Studies - Health Sciences Series Publisher
journal uses a CC BY-NC-SA license which mean
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
- The licensor cannot revoke these freedoms as long as you follow the license terms.
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
- ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.