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Original article
The clinical significance of fibrinogen plasma levels in patients with diffuse large B cell lymphoma
  1. Katharina T Troppan1,
  2. Thomas Melchardt2,
  3. Kerstin Wenzl1,
  4. Konstantin Schlick2,
  5. Alexander Deutsch1,
  6. Marc D Bullock3,
  7. Daniel Reitz4,
  8. Christine Beham-Schmid5,
  9. Lukas Weiss2,
  10. Daniel Neureiter6,
  11. Wolfgang Tränkenschuh6,
  12. Richard Greil2,
  13. Peter Neumeister1,
  14. Alexander Egle2,
  15. Martin Pichler3
  1. 1Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
  2. 23rd 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
  3. 3Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  4. 4Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
  5. 5Institute of Pathology, Medical University of Graz (MUG), Graz, Austria
  6. 6Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
  1. Correspondence to Professor Martin Pichler, Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; mpichler{at}mdanderson.org

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.

  • LYMPHOMA
  • MALIGNANT TUMOURS
  • HAEMATOLOGY

https://doi.org/10.1136/jclinpath-2015-203356

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