Tumor Abnormal Protein Level Predicts Disease Response and Progression of Diffuse Large B-Cell Lymphoma in the Rituximab Era.

Abstract

Changes of glycoprotein are hallmarks for various malignancies; however, the prognostic impact in diffuse large B-cell lymphoma (DLBCL) has not been well elucidated. Here we used serum tumor abnormal protein (TAP) level, a lectin-based agglutination assay, to investigate the clinical value of circulating glycoprotein level in DLBCL. One hundred and thirty-one newly diagnosed DLBCL patients treated by rituximab combined chemotherapy were retrospectively enrolled, all with data available for TAP level at initial diagnosis. Additionally, TAP levels during and after initial treatments were measured in 97 cases. Our results showed elevated pre-treatment TAP level was significantly associated with shorter progression-free survival (PFS, p = 0.019) and overall survival (OS, p = 0.025), especially in the high-risk subgroups. In the multivariate Cox regression analyses, pre-treatment TAP level was an independent predictive factor for PFS (p = 0.048). Moreover, ≥ 25% decrease of TAP level indicated superior PFS (p = 0.006) and OS (p = 0.024) in patients with elevated TAP levels at diagnosis. In cases which achieved complete or partial remission, TAP levels were significantly reduced during treatment, but not in non-responsive or progressed patients. TAP level is a strong prognostic tool for predicting disease progression and monitoring individual response for DLBCL in the rituximab era.