| Abstract: | This study compared the value of several simple laboratory parameters with known prognostic models for predicting survival in patients with diffuse large B‐cell lymphoma (DLBCL). The data of 157 adult patients with DLBCL diagnosed at Rabin Medical Center in 2004–2008 and treated with R‐CHOP immunochemotherapy were retrospectively reviewed. Main clinical features of the cohort were as follows: mean age 63.0 years, 43% male, 63% stage III/IV disease, 28% ECOG performance status > 2, 60% elevated lactate dehydrogenase level. Median duration of follow‐up was 6.6 years. The NCCN‐International Prognostic Index (IPI) was found to be a more powerful prognosticator than the IPI. Five‐year overall survival (OS) was 69.6; 73.6% for patients with intermediate NCCN‐IPI and 38.4% for patients with poor NCCN‐IPI. On univariate analysis, pretreatment hemoglobin and albumin levels were significantly associated with survival. By albumin level, 5‐year OS was 77.6 + 4% in patients with >3.5 g/dl and 53 + 7% in patients with < 3.5 g/dl (p < 0.001); 5‐year progression‐free survival (PFS) was 69.9% and 50.9%, respectively (p = 0.002). By hemoglobin level, 5‐year OS was 82.9 + 4.5% in patients with >12 g/dl and 58.8 + 5% in patients with < 12 g/dl (p = 0.007); 5‐year PFS was 75.5% and 54.1%, respectively (p = 0.008). On multivariate analysis with Cox regression, pretreatment albumin level was a significant independent predictor of OS. Furthermore, 5‐year OS of patients with a high NCCN‐IPI and albumin < 3.5 g/dl was 29.2% compared with 60% in patients with albumin > 3.5 g/dl (p = 0.022). In conclusion, pretreatment albumin level is a strong prognostic factor for OS in patients with DLBCL and can discriminate high‐risk patients for good and poor prognosis. Copyright © 2015 John Wiley & Sons, Ltd. |
