Cancer Antigen 125 Serum Level in Head and Neck Diffuse Large B-Cell Lymphoma

Abstract Abstract 1609 Background: Angiogenesis is gaining importance in hematological malignancies; it is regulated by a balance of various enhancing and inhibiting angiogenic factors. However, studies related to the prognostic value of angiogenic factors and aggressive Non-Hodgkin lymphomas are limited compared to solid tumors. The aim of this study was to determine pretreatment serum level of vascular endothelial growth factor (VEGF) and osteopontin (OPN) in patients with diffuse large B cell lymphoma (DLBCL) and to investigate whether these factors provide prognostic information. METHODS: We measured pretreatment serum levels of VEGF and OPN by Enzyme-Linked Immunosorbent Assay (ELISA) in 67 patients newly diagnosed as diffuse large B-cell lymphoma and in 30 healthy controls. All patients were treated with rituximab-CHOP chemotherapy. RESULTS: The serum OPN levels were found elevated in untreated DLBCL patients compared to controls: in newly diagnosed patients it ranged from 25 to 238 pg/ml; median 94.2 pg/ml while in the healthy controls it ranged from 13 to 46.5 pg/ml; median 30.0 pg/ml (P=0.00008). There were significant differences in the serum VEGF levels between DLBCL patients and controls (median 480.96 pg/ml vs. 163.8 pg/ml, P=0.001). Serum OPN levels higher than the median level were related to advanced Ann Arbor stage (P=0.026), International Prognostic Index of 2 or higher (P=0.005), ECOG III-V (P=0.004). The complete remission rate after treatment was higher in patients with low OPN serum levels than in those with high OPN serum levels (67.5% versus 32.4%, P=0.002). Elevated serum levels of OPN were strongly associated with shorter overall survival (P=0.007) and event-free survival (P=0.04). In multivariate analysis with International Prognostic Index criteria, OPN remained a significant predictor for overall survival (P=0.033). VEGF level was significantly correlated with age (P=0.01) and serum lactate dehydrogenase level (P=0.02), but not strongly correlated with other potential prognostic factors, and it failed to show prognostic significance. CONCLUSION: Our results showed that pretreatment serum level of OPN is significantly related to outcome in DLBCL patients. Ongoing extension study and additional follow-up will provide more information moving forward. Disclosures: No relevant conflicts of interest to declare.

Download Full-text

Role of neutrophil to lymphocyte ratio in addition to revised international prognostic index (R-IPI) in patients with extranodal diffuse large B-cell lymphoma of head and neck.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e19032 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e19032-e19032

Author(s):

Kamila Izabela Cisak ◽

Amitoj Gill ◽

Erin Faber ◽

Rebecca A. Redman ◽

Neal E Dunlap ◽

...

Keyword(s):

B Cell ◽

Head And Neck ◽

Cell Lymphoma ◽

International Prognostic Index ◽

Prognostic Index ◽

B Cell Lymphoma ◽

Monocyte Count ◽

Lymphocyte Ratio ◽

Large B Cell Lymphoma ◽

Large B Cell

e19032 Background: Diffuse large B-cell lymphoma (DLBCL) is the most prevalent subtype of non-Hodgkin lymphoma (NHL). One third of DLBCLs cases have a primary extranodal origin and head and neck localization is second most common localization after gastrointestinal tract. The Revised-International Prognostic Index (r-IPI) is commonly used as prognostic tool, but there is growing evidence that neutrophil to lymphocyte ratio (NLR) also has prognostic significance in DLBCL. Methods: We retrospectively reviewed all cases of extranodal DLBCLs diagnosed between 2006 and 2016 at a single academic institution. Collected data included race, gender, primary site, baseline laboratory data, IPI score, pathology, treatment and survival. Results: A total of 33 patient were included, with 18 (54.5%) being females. Median age at diagnosis was 68 (range 28-92). 15% of patients had a r-IPI of 0, 30% a r-IPI of 1-2, 12% a rIPI of 3-5 and 36% a not evaluable (NE) r-IPI. Twelve (36%) patients had germinal center B cell subtype (GCB) and 17 (51%) patients had activated B cell subtype (ABC) by immunohistochemistry. Among all patients, 13 (39%) had pretreatment NLR equal or more than 3.5 and 11 (33%) patients had NLR less than 3.5 and 9 patients had a NE NLR. . Among deceased patients, 5 (56%) of them had NLR of more that 3.5 (p =0.011). Nine (27%) patients had pretreatment monocyte count less than 700/mm3 and 14 (42%) patients had monocyte count at least 700/mm3 (p=0.611). The 2-year overall survival was 77% (95% CI 0.61 - 0.93). Conclusions: (R-IPI) is the most common tool to predict outcome in DLBCL and our study showed that pretreatment NLR can be used as additional poor prognosis marker for patients with extranodal DLBCL of the head and neck. [Table: see text]

Download Full-text