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Larrabeiti-Etxebarria A, Bilbao-Aldaiturriaga N, Arzuaga-Mendez J, Martin-Arruti M, Cozzuto L, Gaafar A, Ruiz-Diaz I, Guerra I, Martin-Guerrero I, Lopez-Lopez E, Gutierrez-Camino A. microRNA sequencing for biomarker detection in the diagnosis, classification and prognosis of Diffuse Large B Cell Lymphoma. Sci Rep 2023; 13:12159. [PMID: 37500691 PMCID: PMC10374576 DOI: 10.1038/s41598-023-39271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 07/22/2023] [Indexed: 07/29/2023] Open
Abstract
Despite being considered a single disease, Diffuse Large B Cell Lymphoma (DLBCL) presents with variable backgrounds, which results in heterogeneous outcomes among patients, with 40% of them still having primary refractory disease or relapse. Thus, novel biomarkers are needed. In addition, multiple factors regarding its pathogenesis remain unclear. In this context, recent investigations point to the relevance of microRNAs (miRNAs) in cancer. However, regarding DLBCL, there is inconsistency in the data reported. Therefore, in this work, the main goals were to determine a miRNA set with utility as biomarkers for DLBCL diagnosis, classification, prognosis and treatment response, as well as to decipher the mechanism of action of deregulated miRNAs in the origin of the disease. We analyzed miRNA expression in a cohort of 78 DLBCL patients and 17 controls using small RNA sequencing and performed a miRNA-mRNA interaction network analysis. This way, we were able to define new miRNA expression signatures for diagnosis, classification, treatment response and prognosis, and we identified plausible mechanisms of action by which deregulated miRNAs could be involved in DLBCL pathogenesis. In summary, our study remarks that miRNAs could play an important role in DLBCL.
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Affiliation(s)
- Ane Larrabeiti-Etxebarria
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Nerea Bilbao-Aldaiturriaga
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, Leioa, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n, 48940, Leioa, Spain
- Pediatric Oncology Group, BioCruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Javier Arzuaga-Mendez
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, Leioa, Spain
- Hematologic Neoplasm Group, BioCruces Bizkaia Health Research Institute, Barakaldo, Spain
| | | | - Luca Cozzuto
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Ayman Gaafar
- Pathology Department, Cruces University Hospital, Barakaldo, Spain
| | - Irune Ruiz-Diaz
- Pathology Department, Donostia University Hospital, San Sebastián, Spain
| | - Isabel Guerra
- Pathology Department, Araba University Hospital, Vitoria, Spain
| | - Idoia Martin-Guerrero
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, Leioa, Spain
- Pediatric Oncology Group, BioCruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Elixabet Lopez-Lopez
- Department of Biochemistry and Molecular Biology, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n, 48940, Leioa, Spain.
- Pediatric Oncology Group, BioCruces Bizkaia Health Research Institute, Barakaldo, Spain.
| | - Angela Gutierrez-Camino
- Pediatric Oncology Group, BioCruces Bizkaia Health Research Institute, Barakaldo, Spain
- Division of Hematology-Oncology, CHU Sainte-Justine Research Center, Montreal, Canada
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2
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Zhang R, Huang T, Li J, Zhou H, Wang X. Effect of miR-27b on the proliferation and apoptosis of diffuse large b-cell lymphoma cells by targeting the regulation of MET/PI3K/AKT pathway. Discov Oncol 2022; 13:137. [PMID: 36502446 PMCID: PMC9742074 DOI: 10.1007/s12672-022-00589-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study aimed to explore the regulation of miR-27b expression on MET/PI3K/AKT pathway, and to explain its effect on biological functions of DLBCL cells. METHODS The expressions of miR-27b and MET gene in DLBCL cells and normal human B cell lines were determined by qRT-PCR. miR-27b expression in DLBCL cell line Toledo was over-expressed with the cell transfection method. The proliferation of DLBCL cells was determined by MTT. And the invasiveness of DLBCL cells was determined by Transwell. The level of apoptosis in DLBCL cells was determined by ELISA. miR-27b targeting of MET was verified by dual- luciferase reporter assay. The activation of MET/PI3K/AKT pathway and the expression of downstream related proteins were determined by Western blot. RESULTS The results showed that miR-27b was poorly expressed in DLBCL cell lines compared with normal human B cell lines, and was associated with its high proliferation, high invasiveness and low apoptosis level. High miR-27b expression can reduce the proliferation and increase the apoptosis level in DLBCL cells. By examining the effect of miR-27b over-expression on the MET/PI3K/AKT pathway, it was found that miR-27b can inhibit the proliferation and invasiveness and promote the apoptosis of DLBCL cells by targeting the inhibition of MET expression and the activation of PI3K/AKT pathway. CONCLUSION miR-27b can inhibit the proliferation and invasiveness of DLBCL cells and promote the apoptosis of the cells by targeting MET/PI3K/AKT pathway.
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Affiliation(s)
- Rui Zhang
- Department of Hematology, The Second Affiliated Hospital of Qiqihar Medical College, No. 37 Zhonghua West Road, Jianhua District, Qiqihar, 161006, Heilongjiang Province, China
| | - Tianjiao Huang
- Department of Hematology, The Second Affiliated Hospital of Qiqihar Medical College, No. 37 Zhonghua West Road, Jianhua District, Qiqihar, 161006, Heilongjiang Province, China
| | - Jinfeng Li
- Department of Hematology, The Second Affiliated Hospital of Qiqihar Medical College, No. 37 Zhonghua West Road, Jianhua District, Qiqihar, 161006, Heilongjiang Province, China
| | - Hong Zhou
- Department of Hematology, The Second Affiliated Hospital of Qiqihar Medical College, No. 37 Zhonghua West Road, Jianhua District, Qiqihar, 161006, Heilongjiang Province, China
| | - Xuemei Wang
- Department of Hematology, The Second Affiliated Hospital of Qiqihar Medical College, No. 37 Zhonghua West Road, Jianhua District, Qiqihar, 161006, Heilongjiang Province, China.
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3
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Ting CY, Liew SM, Price A, Gan GG, Bee-Lan Ong D, Tan SY, Bee PC. Clinical significance of aberrant microRNAs expression in predicting disease relapse/refractoriness to treatment in diffuse large B-cell lymphoma: A meta-analysis. Crit Rev Oncol Hematol 2019; 144:102818. [PMID: 31733445 DOI: 10.1016/j.critrevonc.2019.102818] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 12/19/2022] Open
Abstract
The clinical significance of aberrantly expressed microRNAs in predicting treatment response to chemotherapy in diffuse large B-cell lymphoma patients (DLBCL) remains uncertain. Feasibility of microRNA testing to predict treatment outcome was evaluated. Twenty-two types of aberrantly expressed microRNAs were associated with poor treatment response; pooled hazard ratio (HR) was 2.14 [95%CI:1.78-2.57, P < 0.00001]. DLBCL patients with aberrant expression of miR-155, miR-17/92 clusters, miR-21, miR-224, or miR-146b-5p had a higher risk of treatment resistance or shorter period of disease relapse/progression free survival, with HR = 2.71 (95%CI:1.66-4.42, P < 0.0001), HR = 2.70 (95%CI:1.50-4.85, P = 0.0010), HR = 2.20 (95%CI:1.31-3.69, P = 0.003), HR = 2.07 (95%CI:1.50-2.86, P < 0.00001), HR = 2.26 (95%CI:1.40-3.65, P = 0.0009), respectively. The association between aberrant expression of microRNAs and treatment response appears to be stronger in formalin-fixed-paraffin-embedded tissue (HR = 2.41, 95%CI:1.79-3.25, P < 0.00001) than in fresh-frozen samples (HR = 1.94, 95%CI: 1.22-3.08, P = 0.005) and peripheral blood samples (HR = 1.94, 95%CI:1.53-2.46, P < 0.00001). Mir-155, miR-17/92 clusters, miR-21, miR-224, and mir-146b-5p have value in predicting treatment response to chemotherapy in DLBCL.
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Affiliation(s)
- Choo-Yuen Ting
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Su-May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Amy Price
- University of Oxford, Centre for Evidence Based Medicine, England, United Kingdom
| | - Gin-Gin Gan
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Diana Bee-Lan Ong
- Department of Pathology, Faculty of Medicine, University of Malaya, Malaysia
| | - Soo-Yong Tan
- Department of Pathology, National University of Singapore, Singapore
| | - Ping-Chong Bee
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia.
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4
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Zhang S, Wang L, Cheng L. Aberrant ERG expression associates with downregulation of miR-4638-5p and selected genomic alterations in a subset of diffuse large B-cell lymphoma. Mol Carcinog 2019; 58:1846-1854. [PMID: 31237044 DOI: 10.1002/mc.23074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/22/2019] [Accepted: 05/31/2019] [Indexed: 12/19/2022]
Abstract
ERG (avian v-ets erythroblastosis virus E26 oncogene homolog), an oncoprotein in prostate carcinoma and Ewing's sarcoma is associated with poor prognosis in patients with acute myeloid leukemia and T lymphoblastic leukemia. However little is known about ERG in lymphoma. Here we studied ERG in diffuse large B-cell lymphoma (DLBCL) by immunohistochemistry, fluorescence in situ hybridization (FISH), genome-wide microRNA (miRNA) expression profiling, real-time reverse-transcriptase polymerase chain reaction (RT-PCR) and whole exome sequencing (WES). Approximately 30% of de novo DLBCLs (37 of 118) expressed ERG (ERG+). ERG expression showed no significant correlation with DLBCL cell-of-origin classification, patient's age, sex, nodal, or extranodal disease status, tumor expression of p53 or p63. There was no ERG rearrangement in 10 randomly selected ERG+ DLBCLs by FISH. Forty-three miRNAs showed significant differential expression between ERG+ and ERG- DLBCLs. Downregulation of miR-4638-5p was confirmed by real-time RT-PCR. WES not only confirmed known gene mutations in DLBCLs but also revealed multiple novel gene mutations in POLA1, E2F1, PSMD8, AXIN1, GAB2, and GNB2L1, which occur more frequently in ERG+ DLBCLs. In conclusion, our studies demonstrated aberrant ERG expression in a subset of DLBCL, which is associated with downregulation of miR-4638-5p. In comparison with ERG-negative DLBCL, ERG+ DLBCL more likely harbors mutations in genes important in cell cycle control, B-cell receptor-mediated signaling and degradation of β-catenin. Further clinicopathological correlation and functional studies of ERG-related miRNAs and pathways may provide new insight into the pathogenesis of DLBCL and reveal novel targets for better management of patients with DLBCL.
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Affiliation(s)
- Shanxiang Zhang
- Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lin Wang
- Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Liang Cheng
- Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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5
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Systematic Review of the Potential of MicroRNAs in Diffuse Large B Cell Lymphoma. Cancers (Basel) 2019; 11:cancers11020144. [PMID: 30691158 PMCID: PMC6406874 DOI: 10.3390/cancers11020144] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/15/2019] [Accepted: 01/22/2019] [Indexed: 02/08/2023] Open
Abstract
Diffuse large B cell lymphoma (DLBCL) is the most common subtype of invasive non-Hodgkin’s lymphoma (NHL). DLBCL presents with variable backgrounds, which results in heterogeneous outcomes among patients. Although new tools have been developed for the classification and management of patients, 40% of them still have primary refractory disease or relapse. In addition, multiple factors regarding the pathogenesis of this disease remain unclear and identification of novel biomarkers is needed. In this context, recent investigations point to microRNAs as useful biomarkers in cancer. The aim of this systematic review was to provide new insight into the role of miRNAs in the diagnosis, classification, treatment response and prognosis of DLBCL patients. We used the following terms in PubMed” ((‘Non-coding RNA’) OR (‘microRNA’ OR ‘miRNA’ OR ‘miR’) OR (‘exosome’) OR (‘extracellular vesicle’) OR (‘secretome’)) AND (‘Diffuse large B cell lymphoma’ OR ‘DLBCL’)” to search for studies evaluating miRNAs as a diagnosis, subtype, treatment response or prognosis biomarkers in primary DLBCL in human patient populations. As a result, the analysis was restricted to the role of miRNAs in tumor tissue and we did not consider circulating miRNAs. A total of thirty-six studies met the inclusion criteria. Among them, twenty-one were classified in the diagnosis category, twenty in classification, five in treatment response and nineteen in prognosis. In this review, we have identified miR-155-5p and miR-21-5p as miRNAs of potential utility for diagnosis, while miR-155-5p and miR-221-3p could be useful for classification. Further studies are needed to exploit the potential of this field.
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6
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Bedewy AML, Elmaghraby SM, Shehata AA, Kandil NS. Prognostic Value of miRNA-155 Expression in B-Cell Non-Hodgkin Lymphoma. Turk J Haematol 2017; 34:207-212. [PMID: 28148469 PMCID: PMC5544039 DOI: 10.4274/tjh.2016.0286] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: MicroRNA-155 (miRNA-155) resides within the B-cell integration cluster gene on chromosome 21. It can act either as an oncogene or as a tumor-suppressor gene, depending on the cell background in which miRNA-155 is performing its specific target gene controlling function. Therefore, the aim of this study was to investigate miRNA-155 expression in patients with B-cell non-Hodgkin lymphoma (NHL) and its relation to disease prognosis in diffuse large B-cell lymphoma (DLBCL) patients. Materials and Methods: Reverse transcription-polymerase chain reaction assay was performed to evaluate the expression levels of miRNA-155 in 84 patients with newly diagnosed B-cell NHL and 15 normal controls. Results: Compared with normal controls, miRNA-155 expression was significantly upregulated in patients. Moreover, higher levels of miRNA-155 were associated with the presence of B symptoms, involvement of extranodal sites, and high Eastern Cooperative Oncology Group (ECOG) score. Higher levels of miRNA-155 in DLBCL were associated with non-germinal B-cell-like type, the presence of B symptoms, involvement of extranodal sites, and higher International Prognostic Index (IPI) and ECOG scores. Only the high IPI score and high miRNA-155 expression indicated a higher risk of lower event-free survival using multivariate Cox regression analysis. Our data demonstrated that the expression of miRNA-155 was upregulated in newly diagnosed B-cell NHL patients. miRNA-155 is expressed at a lower level in GCB-subtype DLBCL. Low IPI score and miRNA-155 expression were predictors of longer event-free survival. Conclusion: Despite contradicting literature reports, the current findings suggest the potential value of miRNA-155 as a biomarker of prognosis and monitoring in B-cell NHL, and especially that of the DLBCL type.
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Affiliation(s)
- Ahmed M L Bedewy
- Alexandria University Faculty of Medicine, Medical Research Institute, Alexandria Governorate, Egypt
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7
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Lithwick-Yanai G, Dromi N, Shtabsky A, Morgenstern S, Strenov Y, Feinmesser M, Kravtsov V, Leon ME, Hajdúch M, Ali SZ, VandenBussche CJ, Zhang X, Leider-Trejo L, Zubkov A, Vorobyov S, Kushnir M, Goren Y, Tabak S, Kadosh E, Benjamin H, Schnitzer-Perlman T, Marmor H, Motin M, Lebanony D, Kredo-Russo S, Mitchell H, Noller M, Smith A, Dattner O, Ashkenazi K, Sanden M, Berlin KA, Bar D, Meiri E. Multicentre validation of a microRNA-based assay for diagnosing indeterminate thyroid nodules utilising fine needle aspirate smears. J Clin Pathol 2016; 70:500-507. [PMID: 27798083 PMCID: PMC5484037 DOI: 10.1136/jclinpath-2016-204089] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 12/20/2022]
Abstract
AIMS The distinction between benign and malignant thyroid nodules has important therapeutic implications. Our objective was to develop an assay that could classify indeterminate thyroid nodules as benign or suspicious, using routinely prepared fine needle aspirate (FNA) cytology smears. METHODS A training set of 375 FNA smears was used to develop the microRNA-based assay, which was validated using a blinded, multicentre, retrospective cohort of 201 smears. Final diagnosis of the validation samples was determined based on corresponding surgical specimens, reviewed by the contributing institute pathologist and two independent pathologists. Validation samples were from adult patients (≥18 years) with nodule size >0.5 cm, and a final diagnosis confirmed by at least one of the two blinded, independent pathologists. The developed assay, RosettaGX Reveal, differentiates benign from malignant thyroid nodules, using quantitative RT-PCR. RESULTS Test performance on the 189 samples that passed quality control: negative predictive value: 91% (95% CI 84% to 96%); sensitivity: 85% (CI 74% to 93%); specificity: 72% (CI 63% to 79%). Performance for cases in which all three reviewing pathologists were in agreement regarding the final diagnosis (n=150): negative predictive value: 99% (CI 94% to 100%); sensitivity: 98% (CI 87% to 100%); specificity: 78% (CI 69% to 85%). CONCLUSIONS A novel assay utilising microRNA expression in cytology smears was developed. The assay distinguishes benign from malignant thyroid nodules using a single FNA stained smear, and does not require fresh tissue or special collection and shipment conditions. This assay offers a valuable tool for the preoperative classification of thyroid samples with indeterminate cytology.
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Affiliation(s)
| | - Nir Dromi
- Rosetta Genomics Ltd, Rehovot, Israel
| | - Alexander Shtabsky
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Sara Morgenstern
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Yulia Strenov
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Meora Feinmesser
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Vladimir Kravtsov
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Meir Medical Center, Kfar Saba, Israel
| | - Marino E Leon
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Marián Hajdúch
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Syed Z Ali
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Xinmin Zhang
- Temple University Hospital, Philadelphia, Pennsylvania, USA.,Cooper University Hospital, Cooper Medical School of Rowan University at Camden, New Jersey, USA
| | - Leonor Leider-Trejo
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Asia Zubkov
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sergey Vorobyov
- National Centre of Clinical and Morphological Diagnostics, St Petersburg, Russia
| | | | - Yaron Goren
- Rosetta Genomics Ltd, Rehovot, Israel.,Geha Mental Health Center, Petach Tikva, Israel
| | | | | | - Hila Benjamin
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | - Alexis Smith
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | - Mats Sanden
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | - Eti Meiri
- Rosetta Genomics Ltd, Rehovot, Israel
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8
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Prochazka KT, Melchardt T, Posch F, Schlick K, Deutsch A, Beham-Schmid C, Weiss L, Gary T, Neureiter D, Klieser E, Greil R, Neumeister P, Egle A, Pichler M. NCCN-IPI score-independent prognostic potential of pretreatment uric acid levels for clinical outcome of diffuse large B-cell lymphoma patients. Br J Cancer 2016; 115:1264-1272. [PMID: 27764838 PMCID: PMC5104895 DOI: 10.1038/bjc.2016.325] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/12/2016] [Accepted: 09/19/2016] [Indexed: 12/22/2022] Open
Abstract
Background: Blood-based parameters are gaining increasing interest as potential prognostic biomarkers in patients with diffuse large B-cell lymphoma (DLBCL). The aim of this study was to comprehensively evaluate the prognostic significance of pretreatment plasma uric acid levels in patients with newly diagnosed DLBCL. Methods: The clinical course of 539 DLBCL patients, diagnosed and treated between 2004 and 2013 at two Austrian high-volume centres with rituximab-based immunochemotherapy was evaluated retrospectively. The prognostic influence of uric acid on overall survival (OS) and progression-free survival (PFS) were studied including multi-state modelling, and analysis of conditional survival. Results: Five-year OS and PFS were 50.4% (95% CI: 39.2–60.6) and 44.0% (33.4–54.0) in patients with uric acid levels above the 75th percentile of the uric acid distribution (Q3, cut-off: 6.8 mg dl−1), and 66.2% (60.4–71.5) and 59.6% (53.7–65.0%) in patients with lower levels (log-rank P=0.002 and P=0.0045, respectively). In univariable time-to-event analysis, elevated uric acid levels were associated with a worse PFS (hazard ratio (HR) per 1 log increase in uric acid 1.47, 95% CI: 1.10–1.97, P=0.009) and a worse OS (HR=1.60, 95% CI: 1.16–2.19, P=0.004). These associations prevailed upon multivariable adjustment for the NCCN-IPI score. Uric acid levels significantly improved the predictive performance of the R-IPI and NCCN-IPI scores, and in multi-state analysis, it emerged as a highly significant predictor of an increased risk of death without developing recurrence (transition-HR=4.47, 95% CI: 2.17–9.23, P<0.0001). Conclusions: We demonstrate that elevated uric acid levels predict poor long-term outcomes in DLBCL patients beyond the NCCN-IPI risk index.
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Affiliation(s)
- Katharina T Prochazka
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | - Thomas Melchardt
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Florian Posch
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | - Konstantin Schlick
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Alexander Deutsch
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | | | - Lukas Weiss
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Thomas Gary
- Division of Angiology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Eckhard Klieser
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Richard Greil
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Peter Neumeister
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria
| | - Alexander Egle
- Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University Salzburg, Salzburg 5020, Austria
| | - Martin Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz 8036, Austria.,Research Unit for non-coding RNAs and genome editing in cancer, Graz 8036, Austria.,Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
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9
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Troppan KT, Melchardt T, Wenzl K, Schlick K, Deutsch A, Bullock MD, Reitz D, Beham-Schmid C, Weiss L, Neureiter D, Tränkenschuh W, Greil R, Neumeister P, Egle A, Pichler M. The clinical significance of fibrinogen plasma levels in patients with diffuse large B cell lymphoma. J Clin Pathol 2015; 69:326-30. [PMID: 26644520 DOI: 10.1136/jclinpath-2015-203356] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 09/17/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fibrinogen plays a crucial role in the pathophysiology of tumour cell growth, invasion and metastasis. The aim of this study was to evaluate the prognostic significance of pretreatment plasma fibrinogen levels in patients with diffuse large B cell lymphoma (DLBCL) METHODS: Data from 372 patients with DLBCL, diagnosed and treated between 2004 and 2013 at two Austrian centres, were evaluated retrospectively. The prognostic influences of plasma fibrinogen levels and other factors, including age, tumour stage and the National Comprehensive Cancer Network-International Prognostic Index, on 5-year overall survival (OS) and 5-year disease-free survival (DFS) were studied using Kaplan-Meier curves as well as univariate and multivariate Cox regression models. RESULTS Kaplan-Meier analysis revealed that a high fibrinogen plasma level is associated with decreased 5-year OS and 5-year DFS in patients with DLBCL (p<0.001, log-rank test). Furthermore, in multivariate analysis, elevated serum fibrinogen was found to be an independent marker of poor clinical outcome: 5-year OS (HR=1.69, 95% CI 1.06 to 2.72, p=0.029) and 5-year DFS (HR=1.68, 95% CI 1.08 to 2.61, p=0.021). CONCLUSIONS In the current study, we demonstrate that high plasma fibrinogen levels at diagnosis predict poor outcome in patients with DLBCL. TRIAL REGISTRATION NUMBER 25-434 ex 12713 and 415-EP/73/127-2012.
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Affiliation(s)
- Katharina T Troppan
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - Thomas Melchardt
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria
| | - Kerstin Wenzl
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - Konstantin Schlick
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria
| | - Alexander Deutsch
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - Marc D Bullock
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Daniel Reitz
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | | | - Lukas Weiss
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | - Richard Greil
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria
| | - Peter Neumeister
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - Alexander Egle
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria
| | - Martin Pichler
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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New developments in the pathology of malignant lymphoma: a review of literature published from January 2015 to April 2015. J Hematop 2015; 8:71-79. [PMID: 26146524 PMCID: PMC4481308 DOI: 10.1007/s12308-015-0249-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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