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Diabetes Mellitus Is Associated with Inferior Prognosis in Patients with Chronic Lymphocytic Leukemia: A Propensity Score-Matched Analysis
Rui Gao, Tian-Shuo Man, Jin-Hua Liang, Li Wang, Hua-Yuan Zhu, Wei Wu, Lei Fan, Jian-Yong Li, Tao Yang, Wei Xu
Cancer Res Treat. 2020;52(1):189-206.   Published online July 1, 2019
DOI: https://doi.org/10.4143/crt.2019.122
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Diabetes mellitus (DM) is associated with elevated cancer risk and poor survival outcome in malignancies. The objective of this study was to evaluate the prognostic value of preexisting DM in chronic lymphocytic leukemia (CLL).
Materials and Methods
Six hundred and thirty-three subjects with newly-diagnosed CLL between 2007 and 2016 were recruited. Propensity score-matched method was performed to balance baseline characteristics and eliminate possible bias. Univariate and multivariate Cox regression analyses screened the independent risk indicators for time-to-first-treatment (TTFT) and cancer-specific survival (CSS) of CLL. Receiver operator characteristic curves and the corresponding areas under the curve assessed the predictive accuracy of CLL–International Prognostic Index (IPI) together with DM.
Results
The results showed that 111 patients had pre-existing DM. In the propensity-matched cohort, DM was correlated with inferior TTFT and CSS in CLL patients, and it was an independent prognostic factor for both CSS and TTFT. Pre-diabetics also shared undesirable prognostic outcome compared with patients with no diabetic tendency, and a positive association between longer diabetic duration and poorer prognosis of CLL was identified. DM as one additional point to CLL-IPI had larger area under the curve compared with CLL-IPI alone in CSS prediction and could improve the prognostic capacity of CLL-IPI.
Conclusion
Pre-existing DM was found to be a valuable prognostic predictor and could help predict life expectancy and build refined prognostication models for CLL.

Citations

Citations to this article as recorded by  
  • Molecular Secrets Revealed: How Diabetes may be Paving the Way for Leukemia
    Pouya Goleij, Mohammad Amin Khazeei Tabari, Ahmed Rabie Dahab Ahmed, Leena Mohamed Elamin Mohamed, Ghaida Ahmed Hamed Saleh, Malak Tarig Mohamed Abdu Hassan, Alaa Galal Mohammed Moahmmednoor, Haroon Khan
    Current Treatment Options in Oncology.2024;[Epub]     CrossRef
  • Causal associations between site-specific cancer and diabetes risk: A two-sample Mendelian randomization study
    Rong Xu, Tingjin Zheng, Chaoqun Ouyang, Xiaoming Ding, Chenjin Ge
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Association between diabetes and acute lymphocytic leukemia, acute myeloid leukemia, non-Hopkin lymphoma, and multiple myeloma
    Ji Zhong Zhao, Yu Cheng Lu, Yan Min Wang, Bo Lian Xiao, Hong Yan Li, Shao Chin Lee, Li Juan Wang
    International Journal of Diabetes in Developing Countries.2022; 42(4): 694.     CrossRef
  • Increased serum level of alpha-2 macroglobulin and its production by B-lymphocytes in chronic lymphocytic leukemia
    Regina Michelis, Lama Milhem, Evleen Galouk, Galia Stemer, Ariel Aviv, Tamar Tadmor, Mona Shehadeh, Lev Shvidel, Masad Barhoum, Andrei Braester
    Frontiers in Immunology.2022;[Epub]     CrossRef
  • 8,238 View
  • 177 Download
  • 4 Web of Science
  • 4 Crossref
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Prognostic Value of Baseline and Interim Total Metabolic Tumor Volume and Total Lesion Glycolysis Measured on 18F-FDG PET-CT in Patients with Follicular Lymphoma
Jin-Hua Liang, Yun-Ping Zhang, Jun Xia, Chong-Yang Ding, Wei Wu, Li Wang, Lei Cao, Hua-Yuan Zhu, Lei Fan, Tian-Nv Li, Jian-Yong Li, Wei Xu
Cancer Res Treat. 2019;51(4):1479-1487.   Published online March 12, 2019
DOI: https://doi.org/10.4143/crt.2018.649
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
The purpose of this study was to investigate the prognostic significance of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) in patients with follicular lymphoma (FL) at baseline and mid-treatment with 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) scans.
Methods
The study analyzed data from 48 patients with FL who were treated in Jiangsu Province Hospital and reviewed their baseline PET-CT scans. TMTV and TLG were computed by using the absolute value of 2.0, 2.5, and 3.0 thresholding method, respectively.
Results
Median age was 53 years, 75.0% of patients had stage III to IV disease, 43.8% had a Follicular Lymphoma International Prognostic Index 1 (FLIPI1) score of 3 to 5 and 20.8% had a FLIPI2 score of 3 to 5. Receiver operating characteristic (ROC) curve analysis showed the optimal cut-off values for TMTV3.0 and TLG3.0 were 476.4 (sensitivity, 85.7%; specificity, 78.0%; area under the curve [AUC], 0.760; p=0.003) and 2,676.9 (sensitivity, 71.4%; specificity, 78.0%; AUC, 0.760; p=0.003). On multivariable analysis, TMTV3.0 and TLG3.0 were independent predictors of both progression-free survival (PFS) (hazard ratio [HR], 5.406; 95% confidence interval [CI], 1.326 to 22.040; p=0.019 and HR, 6.502; 95% CI, 1.079 to 39.182; p=0.042) and overall survival (OS) (HR, 4.111; 95% CI, 1.125 to 15.027; p=0.033 and HR, 5.885; 95% CI, 1.014 to 34.148; p=0.049). ROC curve analysis showed the optimal cut-off values for ΔTMTV3.0 and ΔTLG3.0 were 66.3% (sensitivity, 85.7%; specificity, 63.4%; AUC, 0.774; p < 0.001) and 64.5% (sensitivity, 85.7%; specificity, 65.9%; AUC, 0.777; p < 0.001).
Conclusion
Baseline TMTV and TLG are strong predictors of PFS and OS in FL. Furthermore, interim TMTV (ΔTMTV > 66.3%) and TLG (ΔTLG > 64.5%) reduction are valuable tools for early treatment response assessment in FL patients.

Citations

Citations to this article as recorded by  
  • Personalised therapy in follicular lymphoma – is the dial turning?
    Kim M. Linton, Lena Specht, Astrid Pavlovsky, Carrie A. Thompson, Eva Kimby, Daphne de Jong, Loretta J. Nastoupil, Anne‐Ségolène Cottereau, Carla Casulo, Clémentine Sarkozy, Jessica Okosun
    Hematological Oncology.2024;[Epub]     CrossRef
  • Metabolic tumor volume predicts outcome in patients with advanced stage follicular lymphoma from the RELEVANCE trial
    A.S. Cottereau, L. Rebaud, J. Trotman, P. Feugier, L.J. Nastoupil, E. Bachy, I.W. Flinn, C. Haioun, L. Ysebaert, N.L. Bartlett, H. Tilly, O. Casasnovas, R. Ricci, C. Portugues, I. Buvat, M. Meignan, F. Morschhauser
    Annals of Oncology.2024; 35(1): 130.     CrossRef
  • Prognostic value of the combination of volume, massiveness and fragmentation parameters measured on baseline FDG pet in high-burden follicular lymphoma
    S. Draye-Carbonnier, V. Camus, S. Becker, D. Tonnelet, E. Lévêque, A. Zduniak, F. Jardin, H. Tilly, P. Vera, P. Decazes
    Scientific Reports.2024;[Epub]     CrossRef
  • Baseline 18F-FDG PET/CT may contribute to the determination of initial treatment strategy for newly diagnosed follicular lymphoma
    Qiao Yang, Hongzhe Zhang, Yan Zhang, Wei Zhang, Daobin Zhou, Yaping Luo
    European Journal of Radiology.2024; 178: 111632.     CrossRef
  • The value of semiquantitative PET features and end‐of‐therapy PET in grade 3B follicular lymphoma
    Allison Barraclough, Sze Ting Lee, Diego Villa, Greg Hapgood, Don Wilson, Geoffrey Chong, Eliza A. Hawkes
    British Journal of Haematology.2024;[Epub]     CrossRef
  • Accuracy and prognostic impact of FDG PET/CT and biopsy in bone marrow assessment of follicular lymphoma at diagnosis: A Nation‐Wide cohort study
    Isabel Ródenas‐Quiñonero, Tzu Chen‐Liang, Taida Martín‐Santos, Antonio Salar, Marta Fernández‐González, Carolina Celades, José‐Tomás Navarro, Ana Belén Martínez‐Garcia, Rafael Andreu, Aitana Balaguer, Alejandro Martin García‐Sancho, Mónica Baile, Javier L
    Cancer Medicine.2023; 12(6): 6536.     CrossRef
  • Prognostic value of 18F-FDG lesion dissemination features in patients with peripheral T-cell lymphoma (PTCL)
    Yiting Xie, Yue Teng, Chong Jiang, Chongyang Ding, Zhengyang Zhou
    Japanese Journal of Radiology.2023; 41(7): 777.     CrossRef
  • Prognostic value of interim 18F-FDG PET/CT in adult follicular lymphoma treated with R-CHOP
    Na Sun, Wenli Qiao, Yan Xing, Taisong Wang, Jinhua Zhao
    Annals of Hematology.2023; 102(4): 795.     CrossRef
  • Early biochemical and radiographic response after one cycle of [177Lu]Lu-PSMA I&T radioligand therapy in metastatic castration-resistant prostate cancer patients
    Wojciech Cytawa, Robin Hendel, Bartłomiej Tomasik, Franz-Xaver Weinzierl, Thorsten Bley, Jacek Jassem, Andreas Schirbel, Andreas K. Buck, Ralph A. Bundschuh, Philipp E. Hartrampf, Rudolf A. Werner, Constantin Lapa
    European Journal of Nuclear Medicine and Molecular Imaging.2023; 50(12): 3765.     CrossRef
  • Early molecular imaging response assessment based on determination of total viable tumor burden in [68Ga]Ga-PSMA-11 PET/CT independently predicts overall survival in [177Lu]Lu-PSMA-617 radioligand therapy
    Florian Rosar, Felix Wenner, Fadi Khreish, Sebastian Dewes, Gudrun Wagenpfeil, Manuela A. Hoffmann, Mathias Schreckenberger, Mark Bartholomä, Samer Ezziddin
    European Journal of Nuclear Medicine and Molecular Imaging.2022; 49(5): 1584.     CrossRef
  • Prognostic significance of clinical characteristics and 18Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma
    Yizhen Liu, Jinjin Jiang, Lianfang Liu, Zezhou Wang, Baohua Yu, Zuguang Xia, Qunling Zhang, Dongmei Ji, Xiaojian Liu, Fangfang Lv, Xiaonan Hong, Shaoli Song, Junning Cao
    Journal of International Medical Research.2022;[Epub]     CrossRef
  • Pre‐treatment total metabolic tumour volumes in lymphoma: Does quantity matter?
    Tarec Christoffer El‐Galaly, Diego Villa, Chan Yoon Cheah, Lars C. Gormsen
    British Journal of Haematology.2022; 197(2): 139.     CrossRef
  • Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT
    Hongyan Li, Min Wang, Yajing Zhang, Fan Hu, Kun Wang, Chenyang Wang, Zairong Gao
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Time to omit interim CT imaging during frontline chemoimmunotherapy for patients with follicular lymphoma?
    Ross Thomas Salvaris, Chan Yoon Cheah
    Leukemia & Lymphoma.2022; 63(14): 3271.     CrossRef
  • Prognostic Values of Baseline 18F-FDG PET/CT in Patients with Peripheral T-Cell Lymphoma
    Yeye Zhou, Xiaoyi Zhang, Haifeng Qin, Zixuan Zhao, Jihui Li, Bin Zhang, Shibiao Sang, Yiwei Wu, Shengming Deng
    BioMed Research International.2020; 2020: 1.     CrossRef
  • The Incremental Prognostic Value of Baseline 18F-FDG PET/CT Imaging in Angioimmunoblastic T-Cell Lymphoma
    Hui Wang, Wenjing Yu, Tao Wu, Yangyang Xue, Dan Zhang, Huiqin Xu
    BioMed Research International.2020; 2020: 1.     CrossRef
  • 9,286 View
  • 210 Download
  • 18 Web of Science
  • 16 Crossref
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Albumin-to-Fibrinogen Ratio as an Independent Prognostic Parameter in Untreated Chronic Lymphocytic Leukemia: A Retrospective Study of 191 Cases
Yi-Xin Zou, Jia Qiao, Hua-Yuan Zhu, Rui-Nan Lu, Yi Xia, Lei Cao, Wei Wu, Hui Jin, Wen-Jie Liu, Jin-Hua Liang, Jia-Zhu Wu, Li Wang, Lei Fan, Wei Xu, Jian-Yong Li
Cancer Res Treat. 2019;51(2):664-671.   Published online August 1, 2018
DOI: https://doi.org/10.4143/crt.2018.358
AbstractAbstract PDFPubReaderePub
Purpose
Chronic lymphocytic leukemia (CLL) is one of the most frequent type of B-cell chronic lymphoproliferative disorders and chronic inflammation takes part in the development of CLL. However, there has been no valid immune biomarker to predict the prognosis of untreated CLL patients.
Materials and Methods
In this retrospective study, we analyzed the clinical correlations and prognostic value of albumin-to-fibrinogen ratio (AFR) detected at diagnosis in 191 CLL patients.
Results
The cut-off value of AFR was 9.7 calculated by X-tile. Patients who were more than 65 years old were often accompanied by low level of AFR (p < 0.001). Survival analysis showed that patients with low level of AFR had shorter overall survival (OS) than patients with high level of AFR (p < 0.001). Multivariate analysis illustrated that AFR had a negative impact on OS (p=0.003) and was independent of parameters involved in CLL international prognostic index and other prognostic markers such as CD38 and ZAP-70.
Conclusion
These data provide a comprehensive view of AFR and shows that AFR at diagnosis is an adverse prognostic factor in untreated CLL patients.

Citations

Citations to this article as recorded by  
  • Fibrinogen-albumin ratio predicts treatment response in phospholipase A2 receptor-associated membranous nephropathy with nephrotic syndrome
    Suyan Duan, Si Chen, Chen Chen, Fang Lu, Ying Pan, Yifei Lu, Qing Li, Simeng Liu, Bo Zhang, Huijuan Mao, Changying Xing, Yanggang Yuan
    Renal Failure.2024;[Epub]     CrossRef
  • The diagnostic value of neutrophil to lymphocyte ratio, albumin to fibrinogen ratio, and lymphocyte to monocyte ratio in Parkinson’s disease: a retrospective study
    Yi-Ming Li, Xiao-Hu Xu, Li-Na Ren, Xiao-Fan Xu, Yi-Long Dai, Rui-Rui Yang, Cheng-Qiang Jin
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • Biomarkers for the diagnosis and treatment of rheumatoid arthritis – a systematic review
    D Abdelhafiz, T Baker, DA Glascow, Ah Abdelhafiz
    Postgraduate Medicine.2023; 135(3): 214.     CrossRef
  • Development and validation of machine learning models for predicting prognosis and guiding individualized postoperative chemotherapy: A real-world study of distal cholangiocarcinoma
    Di Wang, Bing Pan, Jin-Can Huang, Qing Chen, Song-Ping Cui, Ren Lang, Shao-Cheng Lyu
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Albumin-to-fibrinogen ratio is an independent prognostic parameter in de novo non-M3 acute myeloid leukemia
    Yaqun Ding, Xiangyu Qi, Yang Li, Yanni Sun, Jia Wan, Chengxin Luo, Yarui Huang, Qingrong Li, Guixian Wu, Xiaoqing Zhu, Shuangnian Xu
    Clinical and Experimental Medicine.2023; 23(8): 4597.     CrossRef
  • The combination of preoperative fibrinogen-to-albumin ratio and postoperative TNM stage (FAR-TNM) predicts the survival in gastric cancer patients after gastrectomy
    Xunlei Zhang, Xinyue Qiu, Haibing Yin, Wenjing Zhao, Li Song, Xingsong Zhang, Lei Yang, Min Tao
    Biomarkers.2023; 28(8): 714.     CrossRef
  • Prognostic Significance of the Albumin to Fibrinogen Ratio in Peritoneal Dialysis Patients
    Wenkai Xia, Meisi Kuang, Chenyu Li, Xiajuan Yao, Yan Chen, Jie Lin, Hong Hu
    Frontiers in Medicine.2022;[Epub]     CrossRef
  • Distinct Age-Related Clinical Features and Risk Assessment in Chinese With Chronic Lymphocytic Leukemia
    Zheng Tian, Ming Liu, Xiaosheng Fang, Xiangxiang Zhou, Peipei Li, Ying Li, Lingyan Zhang, Fang Liu, Ya Zhang, Xin Wang
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • The Prognostic Value of the Fibrinogen-Albumin-Ratio Index (FARI) in Patients with Advanced Vulvar Cancer
    Arina Onoprienko, Gerda Hofstetter, Tim Dorittke, Christine Bekos, Christoph Grimm, Mariella Polterauer, Thomas Bartl, Stephan Polterauer
    Journal of Personalized Medicine.2022; 12(11): 1882.     CrossRef
  • Systemic Inflammatory Biomarkers, Especially Fibrinogen to Albumin Ratio, Predict Prognosis in Patients with Pancreatic Cancer
    Lin Fang, Fei-Hu Yan, Chao Liu, Jing Chen, Dan Wang, Chun-Hui Zhang, Chang-Jie Lou, Jie Lian, Yang Yao, Bo-Jun Wang, Rui-Yang Li, Shu-Ling Han, Yi-Bing Bai, Jia-Ni Yang, Zhi-Wei Li, Yan-Qiao Zhang
    Cancer Research and Treatment.2021; 53(1): 131.     CrossRef
  • A Novel Biomarker to Screen for Malnutrition: Albumin/Fibrinogen Ratio Predicts Septic Failure and Acute Infection in Patients Who Underwent Revision Total Joint Arthroplasty
    Zulipikaer Maimaiti, Chi Xu, Jun Fu, William Tianyu Li, Wei Chai, Yonggang Zhou, Jiying Chen
    The Journal of Arthroplasty.2021; 36(9): 3282.     CrossRef
  • The Albumin-to-Fibrinogen Ratio Independently Predicts Acute Kidney Injury in Infants With Ventricular Septal Defect Undergoing Cardiac Surgery With Cardiopulmonary Bypass
    Fan Cao, Xinxin Chen, Guodong Huang, Wenhua Liu, Na Zhou, Huili Yuan, Minghui Zou
    Frontiers in Pediatrics.2021;[Epub]     CrossRef
  • Is Serum C- Reactive Protein to Albumin Ratio Be A New Biomarker for Assessing Disease Activity and Quality of Life in Rheumatoid Arthritis?
    Elif BALEVİ BATUR, Funda LEVENDOĞLU
    OSMANGAZİ JOURNAL OF MEDICINE.2021;[Epub]     CrossRef
  • Correlation between albumin to fibrinogen ratio, C-reactive protein to albumin ratio and Th17 cells in patients with rheumatoid arthritis
    Yujue He, Jifeng Tang, Bodeng Wu, Bin Yang, Qishui Ou, Jinpiao Lin
    Clinica Chimica Acta.2020; 500: 149.     CrossRef
  • Albumin-fibrinogen ratio and fibrinogen-prealbumin ratio as promising prognostic markers for cancers: an updated meta-analysis
    Da-wei Sun, Lin An, Guo-yue Lv
    World Journal of Surgical Oncology.2020;[Epub]     CrossRef
  • The prognostic value of plasma fibrinogen level in patients with acute myeloid leukemia: a systematic review and meta-analysis
    Ziyan Zhang, Rui Zhang, Jiaqian Qi, Wenjing Miao, Kun Fang, Changgeng Ruan, Depei Wu, Yue Han
    Leukemia & Lymphoma.2020; 61(11): 2682.     CrossRef
  • Nomogram to Predict Preoperative Occult Peritoneal Metastasis of Gastrointestinal Stromal Tumors (GIST) Based on Imaging and Inflammatory Indexes


    Shao-Jun Xu, Guo-Sheng Lin, Hong-Jian Ling, Ren-Jie Guo, Jie Chen, Yi-Ming Liao, Tao Lin, Yong-Jian Zhou
    Cancer Management and Research.2020; Volume 12: 11713.     CrossRef
  • Preoperative albumin-to-fibrinogen ratio predicts chemotherapy resistance and prognosis in patients with advanced epithelial ovarian cancer
    Wen Yu, Zhongxue Ye, Xi Fang, Xingzhi Jiang, Yafen Jiang
    Journal of Ovarian Research.2019;[Epub]     CrossRef
  • 9,046 View
  • 242 Download
  • 20 Web of Science
  • 18 Crossref
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