Glomerular filtration rate is an independent prognostic factor in patients with B-large cell lymphoma (CROSBI ID 325948)
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Premužić, Vedran ; Bašić-Kinda, Sandra ; Radman, Ivo ; Dujmović, Dino ; Ilić, Ivana ; Živković, Neno ; Maleta, Lucija ; Kralik, Marko ; Dobrenić, Margareta ; Galunić-Bilić, Lea ; Rončević, Pavle ; Vodanović, Marijo ; Aurer, Igor
engleski
Glomerular filtration rate is an independent prognostic factor in patients with B-large cell lymphoma
Chronic kidney dysfunction is associated with increased mortality in multiple cancer types. Preliminary evidence suggests the same to be true for B-large cell lymphomas (B-LCL). To analyze the relationship of glomerular filtration rate (GFR) and outcome of B-LCL in detail we collected data on outcomes of 285 consecutive patients with newly diagnosed B-LCL treated at our institution with standard rituximab-containing regimens who did not have preexisting kidney disease or urinary tract obstruction at presentation. Median age was 59, range 18 to 87, 145 were male and 140 females. Forty-four had GFR < 60mL/min, 123 had 60 to 90mL/ min, and 118 > 90mL/min. Median follow-up of surviving patients was 49 months and estimated 3- year survival 76%. In univariate analysis age (P < .001), GFR (P = .014), stage (P < .001), performance status (P = .044), chemotherapy regimen (P < .01), and international prognostic index (IPI) (P < .001) were statistically significant prognostic factors. In multivariate analysis, age and GFR remained the only independent prognostic factors. Subtracting 1 from the IPI score of patients who had GFR > 90mL/min and IPI > 1 resulted in a prognostic index that divides patients into 3 prognostic groups (low risk = 0–1, intermediate risk = 2–3 and high risk = 4–5) with an acceptable patient distribution frequency (38%, 39%, and 23%, respectively) and improved statistical significance and separation in comparison to IPI (5-year survival rates of 92%, 74%, and 42%, respectively). GFR is an important independent prognostic factor for B-LCL that should be taken into account in clinical decision making and data analysis and probably be incorporated in prognostic indices.
B-large cell, diffuse, glomerular filtration rate, lymphoma, prognosis
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