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Low magnesium levels and prognosis in newly diagnosed diffuse large B-cell lymphoma
Jennifer J Gile1, Matthew Maurer2, Gordon J Ruan1
1Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States.
Insights
Low serum magnesium levels are linked to poorer outcomes in diffuse large B-cell lymphoma (DLBCL) patients. Maintaining magnesium levels above 2.0 mg/dL may improve survival for these individuals.
Area of Science:
- Oncology
- Hematology
- Biochemistry
Background:
- Magnesium (Mg) is vital for cellular functions.
- Previous research indicated low serum Mg (<2.0 mg/dL) correlated with worse outcomes in DLBCL patients post-autologous stem cell transplant (SCT).
Purpose of the Study:
- To investigate the prognostic significance of low serum magnesium in previously untreated diffuse large B-cell lymphoma (DLBCL) patients.
Main Methods:
- Serum magnesium levels were analyzed in 408 untreated DLBCL patients.
- Two magnesium cut-off points were assessed: low (<1.7 mg/dL) and low normal (<2.0 mg/dL).
Main Results:
- 23% of patients presented with low normal serum magnesium levels (<2.0 mg/dL).
- Low normal magnesium was associated with advanced disease stage, increased extranodal involvement, and higher International Prognostic Index scores.
- Low normal serum magnesium correlated with significantly lower overall survival (OS) and event-free survival.
Conclusions:
- Low normal serum magnesium is a potential prognostic marker in untreated DLBCL.
- Further research is warranted to explore Mg replacement therapy targeting levels >2.0 mg/dL to potentially enhance patient survival.
Abstract:
Magnesium (Mg) is an essential element involved in cellular metabolism. We demonstrated that in patients with diffuse large B-cell lymphoma (DLBCL) undergoing autologous stem cell transplant (SCT), those with a serum Mg < 2.0 mg/dL at the time of transplant had worse outcomes. In this study, we aimed to learn the prognostic value of low serum Mg in patients with untreated DLBCL. We analyzed serum from 408 patients and tested 2 Mg cutpoints-low (<1.7 mg/dL) and low normal (<2.0 mg/dL), a range we found associated with lower survival in the SCT group. We found 3% of patients with low levels and 23% with low normal levels. Low normal serum Mg levels were associated with a higher stage at diagnosis, more extranodal involvement, higher international prognostic index score, lower overall survival (OS), and event-free survival. These data warrant testing Mg replacement to a target of >2.0 mg/dL to learn if survival can be improved.
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