The highest prognostic impact of LDH among International Prognostic Indices (IPIs): an explorative study of five IPI factors among patients with DLBCL in the era of rituximab

Park, J. H.; Yoon, Dok Hyun; Kim, D. Y.; Kim, S.; Seo, Su K.; Jeong, Yoong Ki; Lee, S. W.; Park, C. S.; Huh, Jooryung; Suh, Cheolwon

doi:10.1007/s00277-014-2115-z

Cited by 38 publications

(35 citation statements)

References 28 publications

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“…Although most of our patients (86%) had a low ECOG performance status (a prognostic sign well recognized to be good), 84% had a high LDH level. A high LDH level has been found to be an adverse prognostic factor even in the rituximab era . However, in a univariate analysis of our patients, the LDH level was not found to be associated with OS or PFS.…”

Section: Discussioncontrasting

confidence: 70%

Characteristics of primary splenic diffuse large B‐cell lymphoma and role of splenectomy in improving survival

Bairey

Shvidel

Perry

et al. 2015

Cancer

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BACKGROUND: Primary splenic diffuse large B-cell lymphoma (PS-DLBCL), an uncommon type of non-Hodgkin lymphoma, has been investigated only in small patient series before the rituximab era. The therapeutic role of splenectomy in addition to immunochemotherapy is unknown. METHODS: The databases of 7 medical centers in Israel were searched for patients diagnosed with PS-DLBCL in 1982-2013, and clinical, treatment, and outcome data were collected for 87 patients. The mean patient age was 59.6 years; 57.5% were male. RESULTS: Patients presented with abdominal pain (81%), B symptoms (59%), splenomegaly (84%), splenic masses (97%), and high lactate dehydrogenase (LDH) levels (84%); 61% had stage I or II disease. The diagnosis was made with core-needle biopsy in 46 patients and with diagnostic splenectomy in 39 patients. Eighty patients (92%) were treated with cyclophosphamide, doxorubicin, vincristine, and prednisone; 68 (78%) received rituximab. A complete response was achieved in 67 patients (77%), and a partial response was achieved in 8 (9%). At 5 years, the overall survival (OS) rate was 77%, and the progression-free survival (PFS) rate was 67%. When patients were stratified by splenectomy at diagnosis, the OS rates were 91% for splenectomized patients and 68% for nonsplenectomized patients (P 5.08), and the PFS rates were 85% and 55%, respectively (P 5.02). The respective values for the subgroup with early-stage disease were 96% and 63% for OS (P 5.009) and 90% and 51% for PFS (P 5.01). In a multivariate analysis, a low Eastern Cooperative Oncology Group performance status and splenectomy independently predicted better PFS (P <.03). CONCLUSIONS: Patients with PS-DLBCL usually present with abdominal pain, high LDH levels, and a splenic mass. This study shows for the first time that splenectomy at diagnosis improves survival, specifically in patients with early-stage disease.

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Section: Discussioncontrasting

confidence: 70%

Characteristics of primary splenic diffuse large B‐cell lymphoma and role of splenectomy in improving survival

Bairey

Shvidel

Perry

et al. 2015

Cancer

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“…Serum IgD level correlated with serum β 2 -MG and LDH levels. Many published studies have demonstrated that serum β 2 -MG and LDH levels are associated with the prognosis of DLBCL [36,37] and IPI is a well-established prognostication system for risk stratification of DLBCL [38]. We also found mIgD and IgDR expression was more common in the GCB type of Hans classification.…”

Section: Discussionsupporting

confidence: 60%

Immunoglobulin D (IgD) and IgD receptor expression in diffuse large B-cell lymphoma

Dai

Jia

et al. 2019

Hematology

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Objective: Immunoglobulin D (IgD) levels are often elevated in patients with autoimmune diseases. However, the oncogenic activities of IgD and IgD receptor (IgDR) in diffuse large Bcell lymphoma (DLBCL) have not been reported in detail. Therefore, we aimed to investigate the expression of IgD and IgDR in patients with DLBCL. Methods: Membrane IgD (mIgD) and IgDR expression in tissue samples was analyzed using IHC, mIgD and IgDR expression on peripheral blood mononuclear cells (PBMCs) was analyzed by FCM, and secreted IgD (sIgD) level was analyzed by ELISA. Fisher's exact test and Spearman correlation analysis were used to evaluate the relationship between IgD, IgDR, and clinical parameters. Results: The pathological lymph nodes of 34 patients with DLBCL were studied, and mIgD and IgDR expression was found in 16 and 19 patients. mIgD and IgDR expression was upregulated in patients with DLBCL and mIgD expression was significantly associated with IgDR expression. Further correlation analysis showed that mIgD expression was correlated with serum β 2-MG level and Hans algorithm as germinal center B (GCB), whereas IgDR expression correlated with serum LDH level, IPI score and GCB. ELISA showed that sIgD level was significantly increased in DLBCL patients and it correlated with serum β 2-MG and LDH levels. FCM showed that mIgD and IgDR expression in PBMCs of patients with DLBCL was significantly higher than that in healthy controls. Conclusion: Our findings suggest that overexpression of IgD and IgDR is an abnormal activation state in DLBCL.

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“…Additionally, elevated LDH levels are independently predictive of adverse clinical outcomes. 32,33 To compare the performance of Ig-HTS detection of disease from plasma or circulating cells, we assessed blood draws from patients with active disease (time of initial diagnosis or relapse) as measured by PET/CT. At these paired time points, LDH had a sensitivity of 59% (20 of 34) compared with 88% (30 of 34) by plasma Ig-HTS (P 5 .01; Figure 2B).…”

Section: Detection Of Molecular Disease In Plasma In Relation To Lactmentioning

confidence: 99%

Noninvasive monitoring of diffuse large B-cell lymphoma by immunoglobulin high-throughput sequencing

Kurtz¹,

Green²,

Bratman³

et al. 2015

Blood

290

266

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Key Points• DLBCL can be detected in the blood by immunoglobulin high-throughput sequencing (Ig-HTS) with high specificity.• Although DLBCL can be detected in leukocytes or plasma by Ig-HTS, plasma has greater sensitivity and more accurately reflects disease.Recent studies have shown limited utility of routine surveillance imaging for diffuse large B-cell lymphoma (DLBCL) patients achieving remission. Detection of molecular disease by immunoglobulin high-throughput sequencing (Ig-HTS) from peripheral blood provides an alternate strategy for surveillance. We prospectively evaluated the utility of Ig-HTS within 311 blood and 105 tumor samples from 75 patients with DLBCL, comparing Ig-HTS from the cellular (circulating leukocytes) and acellular (plasma cell-free DNA) compartments of peripheral blood to clinical outcomes and 18 fluoro-deoxyglucose positron emission tomography combined with computed tomography (PET/CT; n 5 173). Clonotypic immunoglobulin rearrangements were detected in 83% of patients with adequate tumor samples to enable subsequent monitoring in peripheral blood. Molecular disease measured from plasma, compared with circulating leukocytes, was more abundant and better correlated with radiographic disease burden. Before treatment, molecular disease was detected in the plasma of 82% of patients compared with 71% in circulating cells (P 5 .68). However, molecular disease was detected significantly more frequently in the plasma at time of relapse (100% vs 30%; P 5 .001). Detection of molecular disease in the plasma often preceded PET/CT detection of relapse in patients initially achieving remission. During surveillance time points before relapse, plasma Ig-HTS demonstrated improved specificity (100% vs 56%, P < .0001) and similar sensitivity (31% vs 55%, P 5 .4) compared with PET/CT. Given its high specificity, Ig-HTS from plasma has potential clinical utility for surveillance after complete remission. (Blood. 2015;125(24):3679-3687)

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The highest prognostic impact of LDH among International Prognostic Indices (IPIs): an explorative study of five IPI factors among patients with DLBCL in the era of rituximab

Cited by 38 publications

References 28 publications

Characteristics of primary splenic diffuse large B‐cell lymphoma and role of splenectomy in improving survival

Characteristics of primary splenic diffuse large B‐cell lymphoma and role of splenectomy in improving survival

Immunoglobulin D (IgD) and IgD receptor expression in diffuse large B-cell lymphoma

Noninvasive monitoring of diffuse large B-cell lymphoma by immunoglobulin high-throughput sequencing

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