| Popis: |
Weiling Zhou,1 Weijing Li,2 Cuiying He,2 Ruijuan Ma,2 Qian Gao,1 Yuan Wang,1 Lei Feng,1 Lihong Liu2 1Department of Endocrine and Metabolic Diseases, The Fourth Hospital of Hebei Medical University (Hebei Tumor Hospital), Shijiazhuang, Peopleâs Republic of China; 2Department of Hematology, The Fourth Hospital of Hebei Medical University (Hebei Tumor Hospital), Shijiazhuang, Peopleâs Republic of ChinaCorrespondence: Lihong Liu, Department of Hematology, The Fourth Hospital of Hebei Medical University (Hebei Tumor Hospital), Shijiazhuang, Peopleâs Republic of China, Tel +86 13831177920, Email liulihong111222@163.comPurpose: To explore the effects of primary and secondary hyperglycemia and the application of the hypoglycemic drug metformin on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods: We performed a retrospective analysis of 1767 DLBCL patients.Cox regression method was used for analysis to evaluate the prognostic factors, and the Kaplan-Meier method was used to draw a survival curve to analyze the effect of hyperglycemia and the hypoglycemic drug metformin on the progression-free survival (PFS) and overall survival (OS) of DLBCL patients.Results: Our study showed that patients with hyperglycemia tend to have higher age (age> 60 years), high body mass index (BMI)(⥠24kg/m2), late Ann Arbor stage (IIIâIV), high international prognostic index (IPI) (3â 5 score), high lactic dehydrogenase (LDH) level (> 250U/L), bulky disease and comorbidity. Hyperglycemia affects the survival time of the DLBCL population (PFS: adjusted HR 1.41, 95% CI: 1.16â 1.70, P < 0.001, OS: adjusted HR 1.33, 95% CI:1.09â 1.61, P=0.004).Compared with the non-hyperglycemia group, the secondary hyperglycemia increase affects the prognosis of the DLBCL population (P< 0.001). Compared with the secondary hyperglycemia group, the primary hyperglycemia group has a poor prognosis (P< 0.05). For patients with DLBCL and hyperglycemia (732 patients in total), the use of metformin can improve their PFS and OS (PFS: adjusted HR 0.69, 95% CI: 0.49â 0.96, P=0.028, OS: adjusted HR 0.68, 95% CI: 0.49â 0.95, P=0.024).Conclusion: Hyperglycemia and secondary hyperglycemia are related to the poor prognosis of DLBCL population.For patients with DLBCL combined with hyperglycemia, the application of metformin can improve survival rate.Keywords: hyperglycemia, diffuse large B-cell lymphoma, metformin, recrudescence, death, prognosis |
