title: Significance of tumor burden, vascular endothelial growth factor, lactate dehydrogenase and beta-2 microglobulin serum levels in advanced diffuse large B cell lymphoma.
abstract: OBJECTIVE
  Lactate dehydrogenase (LDH) and beta-2 microglobulin (B2M) are incorporated in the so-called "serologic staging system", as independent parameters for predicting time to treatment failure (TTF) and overall survival (OS) for aggressive non-Hodgkin's lymphoma (NHL) patients. Elevated values of serum vascular endothelial growth factor (sVEGF) was associated with poor survival in the largest histological subgroup, the diffuse large B cell (DLBCL) and immunoblastic lymphomas. sVEGF has independent influence on survival in multivariate models when tested together with the components of the International Prognostic Index (IPI). The purpose of this study was to define possible correlations between LDH, B2M levels and the novel prognostic parameter sVEGF, with assessed tumor burden, as another parameter of aggressiveness for advanced-stage DLBCLs.
  
  
  METHODS
  Serum samples were collected from 29 patients with DLBCL, Ann Arbor clinical stages III and IV, to measure pretreatment serum levels of LDH, B2M and sVEGF. Tumor burden was defined as low and high according to criteria's defined by Jagannath and colleagues.
  
  
  RESULTS
  A trend toward significant correlation between high initial levels of sVEGF and high tumor burden was observed (p=0.077). High serum LDH level was strongly associated with high tumor burden (p=0.0091), but B2M correlation with either low or high tumor burden was not confirmed (p=0.249). Complete response (CR) rates (CR vs. non CR) and OS according to tumor burden (low vs. high) showed no statistically significant differences (p=0.245 and p=0.202).
  
  
  CONCLUSIONS
  Our preliminary data confirmed association between serum LDH level and DLBCL burden with a satisfactory sensitivity-specificity relationship. The other two parameters, sVEGF and B2M, failed to demonstrate significant relationship with tumor burden.
authors.affiliation: Institute for Oncology and Radiology of Serbia, Medical Oncology Service, Department of Hematological Oncology, Belgrade, Serbia.
authors.forename: N
authors.initials: N
authors.lastname: Milanovic
authors.forename: S
authors.initials: S
authors.lastname: Matkovic
authors.forename: D
authors.initials: D
authors.lastname: Ristic
authors.forename: S
authors.initials: S
authors.lastname: Jelic
authors.forename: M
authors.initials: M
authors.lastname: Petrovic
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D047368:Tumor Burden; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D001613:beta 2-Microglobulin / Q000097:blood*
chemical_list: D042461:Vascular Endothelial Growth Factor A; D001613:beta 2-Microglobulin; D007770:L-Lactate Dehydrogenase