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[Prognostic Value of Plasma Fibrinogen Levels in Patients with Diffuse Large B-Cell Lymphoma]
Bing Zhang1,2, Lin Lin1, Jian-Min Ji1
1Department of Hematology， The Affiliated Hospital of Nanjing University of Chinese Medicine， Nanjing 210029， Jiangsu Province， China.
Objective:
To assess the prognostic significance of plasma fibrinogen（FIB） levels in patients of diffuse large B-cell lymphoma(DLBCL).
Methods:
We retrospectively analyzed 203 newly diagnosed with DLBCL patients who met the study requirements from November 2016 to May 2024. Based on the receiver operating characteristic (ROC) curve analysis of plasma FIB levels during diagnosis, the critical value of FIB was determined, and patients were divided into high FIB and low FIB groups. The clinical characteristics and relevant laboratory indicators of two groups were compared. The impact of plasma FIB levels on overall survival (OS) were evaluated using Kaplan-Meier curves as well as univariate and multivariate Cox regression analysis. The differences in FIB and other laboratory indicators under different disease states were compared.
Results:
According to the ROC curve, the optimal cut-off value of FIB was 3.49 g/L. Compared with the high FIB group (>3.49 g/L), the low FIB group (≤3.49 g/L) had a significant decrease in neutrophil count (ANC) (P =0.001) and platelet count (PLT) (P =0.027), and a significant increase in prealbumin (PA) (P =0.001). A high FIB level was associated with decreased OS (P =0.005). Univariate analysis results showed that FIB had an impact on survival of patients(HR＝2.031，95%CI : 1.221-3.375, P =0.006). Multivariate analysis showed that higher FIB level was an independent adverse prognostic factor affecting patients survival （HR＝2.684， 95%CI :1.478-4.875, P =0.001）. Compared with patients with newly diagnosed or recurrent DLBCL, patients with complete remission showed a significant decrease in FIB (P ND < 0.001, P R=0.001) and ANC (P ND < 0.001, P R=0.021), as well as an increase in albumin (ALB) (P ND < 0.001, P R=0.018) and PA (P ND < 0.001, P R < 0.001).
Conclusion:
Elevated FIB is a poor prognostic factor for DLBCL patients. The plasma FIB level is correlated with laboratory indicators such as ANC, PLT, PA, and disease status in DLBCL patients. Dynamic monitoring can assist in the early detection of changes in the condition.
