title: Serum level of soluble tumor necrosis factor receptor 2 is associated with the outcome of patients with diffuse large B-cell lymphoma treated with the R-CHOP regimen.
abstract: BACKGROUND
  Serum soluble tumor necrosis factor receptor 2 (sTNFR2) concentration predicted the clinical outcome of patients with aggressive non-Hodgkin's lymphoma including diffuse large B-cell lymphoma (DLBCL) treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) in our previous study. However, after rituximab (R) was introduced in clinical practice, R-CHOP replaced CHOP as the standard therapy for DLBCL.
  
  
  METHODS
  In this study, we re-evaluated the prognostic significance of serum sTNFR2 in 154 patients with DLBCL treated with R-CHOP.
  
  
  RESULTS
  Five-yr overall survival (5-yr OS) rates with sTNFR2 ≥20 ng/mL and <20 ng/mL were 29.2% and 83.3% (P < 0.0001), respectively, and the corresponding 5-yr progression-free survival (5-yr PFS) rates were 26.9% and 76.4% (P < 0.0001), respectively. A multivariate analysis revealed that serum sTNFR2 and complete remission (CR) were independent prognostic factors for both OS (CR: P < 0.0001, sTNFR2: P = 0.0001) and PFS (CR: P < 0.0001, sTNFR2: P = 0.0001). The prognosis of patients with poor risk groups according to the revised International Prognostic Index who also had high serum sTNFR2 was especially poor.
  
  
  CONCLUSIONS
  Serum sTNFR2 might be a powerful prognostic factor for patients with DLBCL in the rituximab era.
authors.affiliation: First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nakamura
authors.forename: Naoe
authors.initials: N
authors.lastname: Goto
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsurumi
authors.forename: Masao
authors.initials: M
authors.lastname: Takemura
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kanemura
authors.forename: Senji
authors.initials: S
authors.lastname: Kasahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuda
authors.forename: Masahito
authors.initials: M
authors.lastname: Shimizu
authors.forename: Michio
authors.initials: M
authors.lastname: Sawada
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yamada
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Seishima
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takami
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood* / Q000235:genetics; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D015870:Gene Expression; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood* / Q000235:genetics; D000069283:Rituximab; D016019:Survival Analysis; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; C571759:R-CHOP protocol; D047889:Receptors, Tumor Necrosis Factor, Type II; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: diffuse large B-cell lymphoma; lymphoma; prognostic factor; rituximab-CHOP; soluble tumor necrosis factor receptor 2 (sTNFR2)