In:
Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 102, No. 20 ( 2023-05-19), p. e33675-
Abstract:
Chronic kidney dysfunction is associated with increased mortality in multiple cancer types. Preliminary evidence suggests the same to be true for B-large cell lymphomas (B-LCL). To analyze the relationship of glomerular filtration rate (GFR) and outcome of B-LCL in detail we collected data on outcomes of 285 consecutive patients with newly diagnosed B-LCL treated at our institution with standard rituximab-containing regimens who did not have preexisting kidney disease or urinary tract obstruction at presentation. Median age was 59, range 18 to 87, 145 were male and 140 females. Forty-four had GFR 〈 60 mL/min, 123 had 60 to 90 mL/min, and 118 〉 90 mL/min. Median follow-up of surviving patients was 49 months and estimated 3-year survival 76%. In univariate analysis age ( P 〈 .001), GFR ( P = .014), stage ( P 〈 .001), performance status ( P = .044), chemotherapy regimen ( P 〈 .01), and international prognostic index (IPI) ( P 〈 .001) were statistically significant prognostic factors. In multivariate analysis, age and GFR remained the only independent prognostic factors. Subtracting 1 from the IPI score of patients who had GFR 〉 90 mL/min and IPI 〉 1 resulted in a prognostic index that divides patients into 3 prognostic groups (low risk = 0–1, intermediate risk = 2–3 and high risk = 4–5) with an acceptable patient distribution frequency (38%, 39%, and 23%, respectively) and improved statistical significance and separation in comparison to IPI (5-year survival rates of 92%, 74%, and 42%, respectively). GFR is an important independent prognostic factor for B-LCL that should be taken into account in clinical decision making and data analysis and probably be incorporated in prognostic indices.
Type of Medium:
Online Resource
ISSN:
0025-7974
DOI:
10.1097/MD.0000000000033675
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2023
detail.hit.zdb_id:
2049818-4
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