In a nutshell
This study evaluated the significance of the albumin to globulin ratio in pretreated patients with diffuse large B-cell lymphoma. The study concluded that this ratio was useful for predicting treatment outcomes in these patients.
Some background
R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) is the most widely used treatment for diffuse large B-cell lymphoma (DLBCL). However, 10 – 15% of patients develop refractory (does not respond to treatment) disease after this treatment. Another 20 – 25% experience relapse (cancer recurrence).
A new prognostic method is needed to help identify patients who may benefit from other therapy options. The albumin to globulin (two proteins in the blood that may have modified levels in certain diseases, such as cancer) ratio (AGR) has been used as an indicator of other cancers. Whether this ratio can be used to predict prognosis for patients with DLBCL remains unclear.
Methods & findings
This study included the records of 232 patients with DLBCL. All patients received R-CHOP treatment as their first treatment. Based on the AGR before starting treatment, patients were divided into two groups: low ratio (40.1%) or high ratio (59.9%). 56% of patients had stage 3 – 4 disease. Patients were followed-up for an average of 65.45 months. The overall survival (OS; the total time patients diagnosed with the disease are still alive) and progression-free survival (PFS; time following treatment before the disease progresses) were noted.
The low ratio group had a significantly lower average OS (26.87 months) and PFS (14.29 months) than the high ratio group (148.83 months). Having a low AGR was associated with a 70.2% higher risk of having a lower OS and an 85.1% increase in the risk of having a lower PFS compared to having a high AGR before starting treatment.
The low ratio group had a significantly lower complete response (disappearance of all signs of cancer) rate (59.1%) than the high ratio group (81.3%). Also, patients in the low AGR group experienced a significantly higher rate of treatment side effects, such as low blood platelet (cells involved in blood clotting) count (40.9% vs 17.3%) and low neutrophils (white blood cells) with fever (45.2% vs 23%) compared to the high AGR group. Significantly more patients in the low ratio group (28%) stopped treatment due to side effects than the high ratio group (10.1%).
The bottom line
This study concluded that a low albumin to globulin ratio was associated with poorer treatment outcomes in patients with DLBCL.
The fine print
This study was retrospective, meaning it looked back in time to analyze data.
Published By :
Leukemia Research
Date :
Jul 18, 2018
