Skip to main content
SpringerLink
Log in

Prognostic Value of D-Dimer in Patients with Diffuse Large B-cell Lymphoma: A Retrospective Study

  • Published:
Current Medical Science Aims and scope Submit manuscript

Summary

This study evaluated the significance of serum D-Dimer for predicting survival of patients with diffuse large B-cell lymphoma (DLBCL). We analyzed the clinical data from 113 patients who were newly diagnosed with DLBCL at Tongji Hospital from January 2012 to January 2016. The results indicated that there were higher levels of D-Dimer in DLBCL patients with the following characteristics: stage III/IV, lymphocyte monocyte ratio (LMR) <2.27, lactate dehydrogenase (LDH) > upper limit of normal (ULN), albumin (ALB) < 35 g/L, and anemia. After the first chemotherapeutic regimen, D-Dimer was significantly decreased concomitantly with LDH. Cox univariate regression analysis showed that the overall survival (OS) was negatively affected by the following factors: age > 60 years, stage III/W, LDH > ULN, LMR < 2.27, anemia and D-Dimer > 0.92. Multivariate analysis showed that only LDH > ULN (P=0.038) and age > 60 years (P=0.047) were independent adverse prognostic factors. However, it was suggested that D-Dimer could be regarded as a marker of high tumor burden and a potential prognostic screening tool for patients with DLBCL, not otherwise specified (NOS).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Coiffier B, Lepage E, Briere J, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med, 2002,346(4):235–242

    Article  CAS  PubMed  Google Scholar 

  2. Martelli M, Ferreri AJ, Agostinelli C, et al. Diffuse large B-cell lymphoma. Crit Rev Oncol Hematol, 2013,87(2):146–171

    Article  PubMed  Google Scholar 

  3. Sehn LH, Berry B, Chhanabhai M, et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood, 2007,109(5):1857–1861

    Article  CAS  PubMed  Google Scholar 

  4. Vaidya R, Witzig TE. Prognostic factors for diffuse large B-cell lymphoma in the R(X)CHOP era. Ann Oncol, 2014,25(11):2124–2133

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Zhou Z, Sehn LH, Rademaker AW, et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood, 2014,123(6):837–842

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Troppan KT, Melchardt T, Deutsch A, et al. The significance of pretreatment anemia in the era of R-IPI and NCCN-IPI prognostic risk assessment tools: a dual-center study in diffuse large B-cell lymphoma patients. Eur J Haematol, 2015,95(6):538–544

    Article  CAS  PubMed  Google Scholar 

  7. Friedberg JW. New strategies in diffuse large B-cell lymphoma: translating findings from gene expression analyses into clinical practice. Clin Cancer Res, 2011,17(19):6112–6117

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Hong J, Woo HS, Kim H, et al. Anemia as a useful biomarker in patients with diffuse large B-cell lymphoma treated with R-CHOP immunochemotherapy. Cancer Sci, 2014, 105(12):1569–1575

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Adams HJ, de Klerk JM, Fijnheer R, et al. Prognostic Value of Anemia and C-Reactive Protein Levels in Diffuse Large B-Cell Lymphoma. Clin Lymphoma Myeloma Leuk, 2015,15(11):671–679

    Article  PubMed  Google Scholar 

  10. Li ZM, Huang JJ, Xia Y, et al. Blood lymphocyte-to-monocyte ratio identifies high-risk patients in diffuse large B-cell lymphoma treated with R-CHOP. PLoS One, 2012,7(7): e41658

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Porrata LF, Ristow K, Habermann TM, et al. Absolute monocyte/lymphocyte count prognostic score is independent of immunohistochemically determined cell of origin in predicting survival in diffuse large B-cell lymphoma. Leuk Lymphoma, 2012,53(11):2159–2165

    Article  PubMed  Google Scholar 

  12. Bairey O, Shacham-Abulafia A, Shpilberg O, et al. Serum albumin level at diagnosis of diffuse large B-cell lymphoma: an important simple prognostic factor. Hematol Oncol, 2016,34(4):184–192

    Article  CAS  PubMed  Google Scholar 

  13. Dalia S, Chavez J, Little B, et al. Serum albumin retains independent prognostic significance in diffuse large B-cell lymphoma in the post-rituximab era. Ann Hematol, 2014,93(8):1305–1312

    Article  CAS  PubMed  Google Scholar 

  14. Gran OV, Braekkan SK, Hansen JB. Prothrombotic genotypes and risk of venous thromboembolism in cancer. Thromb Res, 2018,164(Suppl 1):S12–S18

    Article  CAS  PubMed  Google Scholar 

  15. Puurunen MK, Enserro D, Xanthakis V, et al. Biomarkers for the prediction of venous thromboembolism in the community. Thromb Res, 2016,145:34–39

    Article  CAS  PubMed  Google Scholar 

  16. Fronas SG, Wik HS, Dahm AEA, et al. Safety of D-dimer testing as a stand-alone test for the exclusion of deep vein thrombosis as compared with other strategies. J Thromb Haemost, 2018,16(12):2471–2481

    Article  CAS  PubMed  Google Scholar 

  17. Eichinger S, Heinze G, Kyrle PA. D-dimer levels over time and the risk of recurrent venous thromboembolism: an update of the Vienna prediction model. J Am Heart Assoc, 2014,3(1): e000467

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Feng JF, Yang X, Chen S, et al. Prognostic Value of Plasma D-dimer in Patients with Resectable Esophageal Squamous Cell Carcinoma in China. J Cancer, 2016,7(12):1663–1667

    Article  PubMed  PubMed Central  Google Scholar 

  19. Desch A, Gebhardt C, Utikal J, et al. D-dimers in malignant melanoma: Association with prognosis and dynamic variation in disease progress. Int J Cancer, 2017,140(4):914–921

    Article  CAS  PubMed  Google Scholar 

  20. Geng Y, Jian C, Yang S, et al. The Prognostic Value of D-Dimer in De Novo Acute Myeloid Leukemia. Am J Med Sci, 2016,352(2):129–133

    Article  PubMed  Google Scholar 

  21. Harris NL, Jaffe ES, Diebold J, et al. The World Health Organization classification of neoplastic diseases of the haematopoietic and lymphoid tissues: Report of the Clinical Advisory Committee Meeting, Airlie House, Virginia, November 1997. Histopathology, 2000, 36(1):69–86

    Article  CAS  PubMed  Google Scholar 

  22. A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Engl J Med, 1993,329(14):987–994

    Article  Google Scholar 

  23. Scartozzi M, Giampieri R, Maccaroni E, et al. Pretreatment lactate dehydrogenase levels as predictor of efficacy of first-line bevacizumab-based therapy in metastatic colorectal cancer patients. Br J Cancer, 2012, 106(5):799–804

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Jung SH, Yang DH, Ahn JS, et al. Serum lactate dehydrogenase with a systemic inflammation score is useful for predicting response and survival in patients with newly diagnosed diffuse large B-cell lymphoma. Acta Haematol, 2015,133(1):10–7

    Article  CAS  PubMed  Google Scholar 

  25. Gatenby RA, Gillies RJ. Why do cancers have high aerobic glycolysis? Nat Rev Cancer, 2004,4(11):891–899

    Article  CAS  PubMed  Google Scholar 

  26. Abdol Razak NB, Jones G, Bhandari M, et al. Cancer-Associated Thrombosis: An Overview of Mechanisms, Risk Factors, and Treatment. Cancers (Basel), 2018,10(10):380

    Article  Google Scholar 

  27. Zanetto A, Campello E, Spiezia L, et al. Cancer-Associated Thrombosis in Cirrhotic Patients with Hepatocellular Carcinoma. Cancers (Basel), 2018, 10(11). pii: E450.

    Article  Google Scholar 

  28. Kilic L, Yildiz I, Sen FK, et al. D-dimer and international normalized ratio (INR) are correlated with tumor markers and disease stage in colorectal cancer patients. Cancer Biomark, 2015,15(4):405–411

    Article  CAS  PubMed  Google Scholar 

  29. Yamamoto M, Yoshinaga K, Matsuyama A, et al. Plasma D-dimer level as a mortality predictor in patients with advanced or recurrent colorectal cancer. Oncology, 2012,83(1):10–5

    Article  PubMed  Google Scholar 

  30. Nishimura K, Ota R, Mikajiri Y, et al. Useful laboratory markers for the diagnosis of bone marrow involvement by malignant lymphoma. Int J Lab Hematol, 2018,40(1):34–40

    Article  CAS  PubMed  Google Scholar 

  31. Borg IH, Bendtsen MD, Bogsted M, et al. Incidence of venous thromboembolism in patients with diffuse large B-cell lymphoma. Leuk Lymphoma, 2016,57(12):2771–2776

    Article  CAS  PubMed  Google Scholar 

  32. Gade IL, Riddersholm SJ, Christiansen I, et al. Venous thromboembolism in chronic lymphocytic leukemia: a Danish nationwide cohort study. Blood Adv, 2018, 2(21):3025–3034

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Lekovic D, Miljic P, Mihaljevic B. Increased risk of venous thromboembolism in patients with primary mediastinal large B-cell lymphoma. Thromb Res, 2010,126(6):477–480

    Article  CAS  PubMed  Google Scholar 

  34. Liu B, Li B, Zhou P, et al. Prognostic value of pretreatment plasma D-dimer levels in patients with diffuse large B cell lymphoma (DLBCL). Clin Chim Acta, 2018,482:191–198

    Article  CAS  PubMed  Google Scholar 

  35. Watanabe R, Tomita N, Itabashi M, et al. Peripheral blood absolute lymphocyte/monocyte ratio as a useful prognostic factor in diffuse large B-cell lymphoma in the rituximab era. Eur J Haematol, 2014,92(3):204–210

    Article  CAS  PubMed  Google Scholar 

  36. Li YL, Gu KS, Pan YY, et al. Peripheral blood lymphocyte/monocyte ratio at the time of first relapse predicts outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma. BMC Cancer, 2014,14:341

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Yan-Li L, Kang-Sheng G, Yue-Yin P, et al. The lower peripheral blood lymphocyte/monocyte ratio assessed during routine follow-up after standard first-line chemotherapy is a risk factor for predicting relapse in patients with diffuse large B-cell lymphoma. Leuk Res, 2014,38(3):323–328

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Both authors contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Yu-di Geng, Jin Jin, Xiao-di Wang, Shu Zhang & Deng-ju Li

  2. College of Mathematics and Statistics, Shenzhen University, Shenzhen, 518060, China

    Yi-ren Chen

Authors
  1. Yu-di Geng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yi-ren Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jin Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiao-di Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Deng-ju Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Deng-ju Li.

Additional information

This work was supported by the National Natural Science Foundation of China (No. 81770168).

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Geng, Yd., Chen, Yr., Jin, J. et al. Prognostic Value of D-Dimer in Patients with Diffuse Large B-cell Lymphoma: A Retrospective Study. CURR MED SCI 39, 222–227 (2019). https://doi.org/10.1007/s11596-019-2023-5

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-019-2023-5

Key words

Search

Navigation