title: Prognostic value of platelet count in diffuse large B-cell lymphoma.
abstract: BACKGROUND
  Besides International Prognostic Index, many parameters have proven prognostic significance in aggressive lymphoma. However, the most appropriate system of risk stratification in diffuse large B-cell lymphoma (DLBCL) is not yet clear. In this study, we attempt to clarify the prognostic value of platelet count at the onset of lymphoma.
  
  
  METHODS
  Between January 2000 and December 2009, 100 patients with DLBCL receiving R-CEOP (rituximab, cyclophosphamide, epirubicin, vincristine, and prednisolone) in a single institution were enrolled. Patient characteristics and survival outcomes were retrospectively analyzed.
  
  
  RESULTS
  Before front-line treatment, 17 patients with thrombocytopenia (< 150 × 10(9)/L) and 83 patients without thrombocytopenia were enrolled. Thrombocytopenic patients initially presented with more B symptoms (P = .040), more bone marrow involvement (P = .001), later staging (P = .001), and higher International Prognostic Index (P < .001). Thrombocytopenia was shown to be an independently poor prognostic factor in the multivariate analysis of overall survival (hazard ratio [HR], 3.405; 95% confidence interval [CI], 1.431-8.101; P = .006) and progression-free survival (HR, 4.299; 95% CI, 1.786-10.343; P = .001).
  
  
  CONCLUSIONS
  Platelet count at diagnosis is a simple but useful indicator for predicting survival outcomes of DLBCL. Although the mechanisms of thrombocytopenia may be complex in lymphoma, further investigations are warranted to illustrate the predictive merit.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, Taiwan, R.O.C. xguaalu@yahoo.com.tw
authors.forename: Ling-Ping
authors.initials: LP
authors.lastname: Chen
authors.forename: Shyh-Jer
authors.initials: SJ
authors.lastname: Lin
authors.forename: Ming-Sun
authors.initials: MS
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood* / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009503:Neutropenia / Q000139:chemically induced; D010976:Platelet Count; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D015251:Epirubicin; D000069283:Rituximab; D014750:Vincristine; D003520:Cyclophosphamide; D011239:Prednisolone