Platelet to lymphocyte ratio (PLR) retains independent prognostic significance in advanced stage marginal zone lymphoma patients treated with rituximab, cyclophosphamide, vincristine, and prednisone combination chemotherapy (R-CVP): Consortium for Improving Survival of Lymphoma trial

Jeongkuk Seo, Won Seog Kim, Jin Seok Kim, Seok Jin Kim, Jae Hoon Lee, Jun Shik Hong, Gyeong Won Lee, Sung Yong Oh, Ji Hyun Lee, Dok Hyun Yoon, Won Sik Lee, Hyo Jung Kim, Jae Yong Kwak, Hye Jin Kang, Jae Cheol Jo, Yong Park, Ho Sup Lee, Hyo Jin Kim, Cheolwon Suh

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8 Scopus citations

Abstract

Background Rituximab plus cyclophosphamide, vincristine, and prednisone (R-CVP) is one of the effective chemotherapeutic regimens for patients with advanced stage marginal zone lymphoma (MZL). However, prognostic factors that affect the outcome of treatment for MZL are not well understood. Methods Between August 2006 and June 2013, patients with newly diagnosed stage III and IV MZL treated with R-CVP as a first-line therapy from 15 institutions were retrospectively analyzed. Patients' clinical and laboratory data at diagnosis were collected by review of medical records. Results A total of 80 patients were analyzed. Bone marrow involvement was observed in 30% cases. Twelve patients (15%) had nodal MZL, and 41.3% patients exhibited multiple mucosa- associated lymphoma tissue sites. Overall response rate was 91.3%, including 73.8% achieving complete response. Advanced MZL patients treated with R-CVP showed a 3-year progression-free survival (PFS) rate of 69.6%. Prognostic markers significantly affecting PFS in univariate analysis were platelet to lymphocyte ratio (PLR, < 95 vs. ≥95, P=0.014), serum albumin (≤3.9 vs. > 3.9 g/dL, P =0.008), and the International Prognostic Index (IPI) score (1 vs. 2-4, P =0.032). In multivariate analysis, only PLR ( < 95 vs. ≥95, HR 0.367, 95% CI, 0.139-0.971, P =0.043) was an independent risk factor for PFS. Conclusion PLR ≥95 at diagnosis is an independent prognostic marker for PFS in advanced stage MZL patients treated with R-CVP. This marker may aid clinicians in predicting the response to R-CVP chemotherapy in stage III and IV MZL patients.

Original languageEnglish (US)
Pages (from-to)200-206
Number of pages7
JournalBlood Research
Volume52
Issue number3
DOIs
StatePublished - 2017

Bibliographical note

Funding Information:
Received on April 29, 2017 Revised on May 28, 2017 Accepted on July 7, 2017 *This work was supported by the Dong-A University Research Fund.

Keywords

  • Marginal zone lymphoma
  • PLR
  • Prognosis
  • R-CVP

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