Baseline Serum Albumin Levels for Predicting Progression-free Survival in Patients with Non-Hodgkin Lymphoma: A Single-center Prospective Study in Syria

Abstract

Abstract BACKGROUND AND AIMS: A low baseline serum albumin (SA) level is considered an adverse prognostic indicator of various solid tumors and hematological malignancies. However, studies evaluating the relationship between SA levels and survival in non-Hodgkin lymphoma (NHL) patients are limited in Syria. Thus, this is the first study to assess the impact of baseline SA as an independent prognostic factor on progression-free survival (PFS) over 18 months (1.5 years) in Syrian NHL patients. METHODS: We prospectively analyzed patients diagnosed with de novo NHL who met the inclusion criteria and were admitted to the Chemotherapy and Radiotherapy Center at Tishreen University Hospital (TUH) in Latakia, Syria, between January 2021 and December 2021. The baseline SA concentration was measured. The PFS rate was estimated using the Kaplan–Meier method. Univariate and multivariate Cox proportional hazard regression analyses were carried out. RESULTS: Sixty patients in total were included. SA’s optimal cutoff value for survival analysis was 3.95 g/dL, according to the receiver operating characteristic (ROC) curve. Patients were categorized into two groups based on that value, 25 (41.7%) had low (≤3.95 g/dL) and 35 (58.3%) had high SA levels (>3.95 g/dL). The PFS rate for 18 months was 56.7%. Kaplan–Meier curves showed that patients with low SA had a significantly inferior PFS rate (28% vs. 77.1%, P < .001). The independent prognostic significance of SA was verified by multivariate analysis. CONCLUSION: Low baseline SA levels (≤3.95 g/dL) could be a simple and effective factor in predicting poor 18-month PFS in Syrian NHL patients. To verify our findings, more extensive research is advised.