Hyperfibrinogenemia is a poor prognostic factor in diffuse large B cell lymphoma.

Area of Science:

• Hematology
• Oncology
• Clinical Pathology

Background:

• Diffuse large B cell lymphoma (DLBCL) is the most prevalent form of non-Hodgkin lymphoma globally.
• Previous research suggests hyperfibrinogenemia may indicate a worse prognosis across various cancer types.

Purpose of the Study:

• To investigate the prognostic significance of hyperfibrinogenemia in patients diagnosed with DLBCL.
• To assess whether hyperfibrinogenemia can serve as an independent predictor of patient outcomes.

Main Methods:

• Retrospective analysis of 228 DLBCL patients diagnosed between May 2009 and February 2016.
• Kaplan-Meier analysis and Cox regression were employed to identify prognostic factors for progression-free survival (PFS) and overall survival (OS).
• Receiver operating characteristic (ROC) curves evaluated predictive accuracy; a novel prognostic index (NPI) was developed by integrating hyperfibrinogenemia with the NCCN-IPI.

Main Results:

• Patients with high National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) scores and advanced stage disease were more prone to hyperfibrinogenemia.
• Hyperfibrinogenemia was significantly associated with inferior PFS (P < 0.001) and OS (P < 0.001).
• Multivariate analysis confirmed hyperfibrinogenemia as an independent predictor of poor outcomes (HR=1.90 for PFS, HR=2.65 for OS).
• The integrated NPI demonstrated superior predictive capability for both PFS (P=0.0194) and OS (P=0.0034) compared to NCCN-IPI alone.

Conclusions:

• Hyperfibrinogenemia is a significant independent prognostic factor for adverse outcomes in DLBCL.
• The predictive accuracy of the NCCN-IPI for DLBCL prognosis can be substantially enhanced by incorporating hyperfibrinogenemia.
• This study highlights the clinical utility of monitoring fibrinogen levels for risk stratification in DLBCL patients, particularly those with advanced disease or high NCCN-IPI scores.