High pretreatment plasma D-dimer levels predict poor survival in patients with diffuse large B-cell lymphoma in the real world.

Abstract

BackgroundData on the role of pretreatment plasma D-dimer levels in the prognostic prediction of patients with diffuse large B-cell lymphoma (DLBCL) are limited. We here studied the potential prognostic roles of pretreatment plasma D-dimer levels in patients with DLBCL.MethodsWe retrospectively analyzed medical records of 308 newly diagnosed patients with DLBCL admitted to the Fujian Medical University Union Hospital between January 2011 and December 2018. Receiver operating characteristic (ROC) curve analysis were used to generate an optimal cut-off value for pretreatment plasma D-dimer levels in patients with DLBCL. According to the cut-off value, all patients were divided into the low D-dimer and high D-dimer groups. We analyzed the relationship between pretreatment plasma D-dimer levels and clinical and laboratory characteristics in patients with DLBCL. Univariate and multivariate analyses were used to assess prognostic factors for overall survival (OS) and progression-free survival (PFS).ResultsPatients with B symptoms, plasma lactate dehydrogenase levels >upper limit of normal (ULN), poor Eastern Cooperative Oncology Group score (2 to 4), advanced stage (III–IV), >1 extranodal site, higher International Prognostic Index (IPI) (2 to 5) and higher National Comprehensive Cancer Network IPI (NCCN-IPI) (≥4) (all P<0.001) had higher pretreatment plasma D-dimer levels (≥1.4 µg/mL). Patients with higher plasma D-dimer levels had worse OS and PFS (P<0.001 and P=0.001, respectively).ConclusionsHigher pretreatment plasma D-dimer level was associated with poor survival and was an independent poor predictor of OS among untreated patients with DLBCL.