Chen Zhang is working in the Department of Gastroenterology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China, the Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
Objective: The presence of serum monoclonal components has been associated with poor outcomes in various haematological malignancies. The current study explored its prognostic role in B-cell non-Hodgkin lymphoma[2-5].
Methods: The clinical indicators and follow-up data of 340 patients with information on serum immunofixation electrophoresis (IFE) at diagnosis were available with B-cell non-Hodgkin lymphoma in our hospital from May 2013 to November 2021 and were retrospectively analyzed. Cox proportional hazard model was used for univariate and multivariate analyses. Kaplan–Meier curves were used to calculate survival rates and draw survival curves. The log-rank test was applied to compare differences between groups.
Results: IFE was positive in 72 patients (21%). Baseline features were comparable between pairs of groups. Poor ECOG PS, B symptoms, advanced stage and high-risk IPI scores were significantly more frequent in the +IFE group. Shorter PFS and OS of B-NHL patients were observed in patients who presented at diagnosis with a +IFE, and IFE was the independent predictor of PFS (HR = 3.212, 95% CI 1.282-8.045, P =0.013 in low-risk lymphomas; HR = 2.598, 95% CI 1.239-5.451, P =0.012 in aggressive lymphomas) and OS (HR =14.693, 95% CI 3.660-58.985, P <0.001 in aggressive lymphomas) in multivariate analysis. Moreover, integrating IFE into the IPI-M1, IPI-M2 and IPI-M3 models improved the area under the curve (AUC) for more accurate survival prediction and prognosis.
Conclusion: Serum monoclonal proteins is a significant prognostic indicator for newly diagnosed B-cell non-Hodgkin lymphoma that can early identify patients with poor prognosis and guide clinical treatment decisions.
Keywords: B cell non-Hodgkin lymphoma; serum monoclonal proteins; serum immunofixation electrophoresis; prognosis; survival