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Pretreatment Hemoglobin Adds Prognostic Information To The NCCN-IPI In Patients With Diffuse Large B-Cell Lymphoma Treated With Anthracycline-Containing Chemotherapy.
Clausen, Michael R; Maurer, Matthew J; Ulrichsen, Sinna Pilgaard; Larsen, Thomas S; Himmelstrup, Bodil; Rønnov-Jessen, Dorthe; Link, Brian K; Feldman, Andrew L; Slager, Susan L; Nowakowski, Grzegorz S; Thompson, Carrie A; Pedersen, Per Trøllund; Madsen, Jakob; Pedersen, Robert S; Gørløv, Jette Sønderskov; Cerhan, James R; Nørgaard, Mette; D'Amore, Francesco.
Afiliación
  • Clausen MR; Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.
  • Maurer MJ; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
  • Ulrichsen SP; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
  • Larsen TS; Department of Hematology, Odense University Hospital, Odense, Denmark.
  • Himmelstrup B; Department of Hematology, Zealand University Hospital, Roskilde, Denmark.
  • Rønnov-Jessen D; Department of Hematology, Sygehus Lillebaelt, Vejle, Denmark.
  • Link BK; Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
  • Feldman AL; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
  • Slager SL; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
  • Nowakowski GS; Department of Medicine, Mayo Clinic, Rochester, MN, USA.
  • Thompson CA; Department of Medicine, Mayo Clinic, Rochester, MN, USA.
  • Pedersen PT; Department of Hematology, Sydvestjysk Sygehus, Esbjerg, Denmark.
  • Madsen J; Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.
  • Pedersen RS; Department of Hematology, Hospitalsenheden Vest, Holstebro, Denmark.
  • Gørløv JS; Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
  • Cerhan JR; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
  • Nørgaard M; Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.
  • D'Amore F; Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.
Clin Epidemiol ; 11: 987-996, 2019.
Article en En | MEDLINE | ID: mdl-31814771
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Clin Epidemiol Año: 2019 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Nueva Zelanda
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Clin Epidemiol Año: 2019 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Nueva Zelanda