Serum high-density lipoprotein cholesterol level has a significant prognostic impact on outcomes of follicular lymphoma patients

Abstract

We investigated the potential of nutritional and inflammatory parameters as prognostic factors for follicular lymphoma (FL), and also examined the predictive value of the early progression of disease within 24 months of first-line chemo-immunotherapy (POD24).We retrospectively analyzed 46 patients with FL admitted to Teikyo University Hospital and treated with chemo-immunotherapy between May 2009 and July 2019. Physical characteristics, blood parameters, and markers or scores for consumptive/ inflammatory and nutritional conditions were used as variables.Nine parameters correlated with poor overall survival (OS) in univariate analysis: An Eastern Cooperative Oncology Group (ECOG) scale performance status (PS) ≥2, five or more involved nodal sites, positive bone marrow (BM) involvement, a serum albumin level <3.5 g/dL, CRP >0.5 mg/dL, lactate dehydrogenase (LD) higher than the upper normal limit (UNL), high-density lipoprotein cholesterol (HDL-C) <40 mg/dL, modified Glasgow prognostic score of 1-2, and the geriatric nutritional risk index <82. In multivariate analysis, ECOG PS ≥2, positive BM involvement, and a serum HDL-C level <40 mg/dL remained significant for poor progression-free survival. One-year OS rate after receiving salvage chemotherapy was lower in the POD24 group (50%) and POD24 correlated with ECOG PS ≥2, positive BM involvement, a serum lactate dehydrogenase >UNL, and HDL-C <40 mg/ dL by Fisher's exact test.These results indicate that low serum HDL-C levels appear to be important for predicting the risk of POD24 and the worse prognosis of FL.Abbreviations: Auto = autologous hematopoietic stem/progenitor cell transplantation, BG = bendamustine and obinutuzumab, BM = bone marrow, BR = bendamustine and rituximab, CI = confidence intervals, CONUT = the controlling nutrition status, CR = Complete remission, CRP = C-reactive protein, CT = computed tomography, DLBCL = diffuse large B-cell lymphoma, ECOG = Eastern Cooperative Oncology Group, FL = follicular lymphoma, FLIPI = follicular lymphoma international prognostic index, GELF = Groupe d'Etude des Lymphomes Folliculaires, GNRI = the geriatric nutritional risk index, HDL-C = high-density lipoprotein cholesterol, HR = hazard ratios, HSCT = hematopoietic stem/progenitor cell transplantation, LD = lactate dehydrogenase, LDL-C = low-density lipoprotein cholesterol, mGPS = the modified Glasgow prognostic score, NHL = non-Hodgkin's lymphoma, OS = overall survival, PFS = progression-free survival, PNI = the prognostic nutritional index, POD = progression of disease, POD24 = progression of disease within 24 months of first-line chemo-immunotherapy,

Elevated serum cathepsin S is associated with HDL3a and HDL3b subclasses in non-Hodgkin lymphoma patients

“…Low levels of HDL-C in haematological cancers indicate that HDL particles may play a crucial role in maintaining strict control over the proliferation and homeostasis of the hematopoietic system, potentially impeding malignant transformation (9,10,30). In this study, significantly lower values of HDL-C were found in both types of lymphoma.…”

“…Besides that, recent evidence suggests that during lymphomagenesis, a decrease in circulating highdensity lipoprotein cholesterol (HDL-C) may exist (9,10). However, some studies indicated that CTSS could potentially affect not only HDL but also lowdensity lipoprotein (LDL) (11).…”

Low Serum Cholesterol Level Is a Significant Prognostic Factor That Improves CLL-IPI in Chronic Lymphocytic Leukaemia

“…Epidemiological association between the cholesterol paradigm and prognosis of haematological cancer was primarily established for HDL-C over the last decade. Correlation between decreased levels of HDL-C and poor clinical outcomes has been consistently reported in follicular lymphoma [ 29 ], extranodal natural killer/T cell lymphoma [ 30 ], malignant lymphoma, and adult T-cell leukaemia-lymphoma [ 31 ], whilst the prognostic potential of the combination of HDL-C together with LDL-C has rarely been investigated. Our findings suggest low TC, HDL-C, and LDL-C levels at diagnosis were clearly associated with unfavourable TTFT and CSS in CLL patients.…”

Geriatric nutritional risk index as a predictor of prognosis in hematologic malignancies: a systematic review and meta-analysis

“…One study reported that GNRI was significantly associated with ICU mortality for HM patients with acute respiratory failure treated in ICU ( 73 ). In Takuji Matsuo’s study, GNRI score < 82 correlated with poor 5-year OS ( 74 ). Another study also demonstrated statistical differences in GNRI values between patients who completed complete six or eight cycles of the standard regimens and those who did not ( 75 ).…”