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Serum level of soluble tumor necrosis factor receptor 2 is associated with the outcome of patients with diffuse large B‐cell lymphoma treated with the R‐ CHOP regimen
Author(s) -
Nakamura Nobuhiko,
Goto Naoe,
Tsurumi Hisashi,
Takemura Masao,
Kanemura Nobuhiro,
Kasahara Senji,
Hara Takeshi,
Yasuda Ichiro,
Shimizu Masahito,
Sawada Michio,
Yamada Toshiki,
Seishima Mitsuru,
Takami Tsuyoshi,
Moriwaki Hisataka
Publication year - 2013
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12139
Subject(s) - international prognostic index , medicine , rituximab , vincristine , chop , gastroenterology , diffuse large b cell lymphoma , lymphoma , prednisolone , cyclophosphamide , b symptoms , regimen , chemotherapy
Background Serum soluble tumor necrosis factor receptor 2 ( sTNFR 2) concentration predicted the clinical outcome of patients with aggressive non‐Hodgkin's lymphoma including diffuse large B‐cell lymphoma (DLBCL) treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) in our previous study. However, after rituximab (R) was introduced in clinical practice, R‐CHOP replaced CHOP as the standard therapy for DLBCL. Patients and methods In this study, we re‐evaluated the prognostic significance of serum sTNFR 2 in 154 patients with DLBCL treated with R‐CHOP. Results Five‐yr overall survival (5‐yr OS) rates with sTNFR 2 ≥20 ng/mL and <20 ng/mL were 29.2% and 83.3% ( P < 0.0001), respectively, and the corresponding 5‐yr progression‐free survival (5‐yr PFS) rates were 26.9% and 76.4% ( P < 0.0001), respectively. A multivariate analysis revealed that serum sTNFR 2 and complete remission (CR) were independent prognostic factors for both OS (CR: P < 0.0001, sTNFR 2: P = 0.0001) and PFS (CR: P < 0.0001, sTNFR 2: P = 0.0001). The prognosis of patients with poor risk groups according to the revised International Prognostic Index who also had high serum sTNFR 2 was especially poor. Conclusion Serum sTNFR 2 might be a powerful prognostic factor for patients with DLBCL in the rituximab era.