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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 
 BLOOD RESEARCH, Vol.52(3) : 200-206, 2017 
Journal Title
Issue Date
Marginal zone lymphoma ; PLR ; Prognosis ; R-CVP
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
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