title: High APRIL but not BAFF serum levels are associated with poor outcome in patients with follicular lymphoma.
abstract: Elevated B cell activation factor (BAFF) and a proliferation-inducing ligand (APRIL) serum levels have been reported to correlate with worse prognosis in B cell-derived malignancies. However, limited information exists regarding the prognostic significance of BAFF and APRIL serum levels in follicular lymphoma (FL). We measured BAFF and APRIL serum levels for 81 patients with newly diagnosed FL and 12 healthy controls. The mean ± standard deviation (SD) BAFF serum level (1,193.86 ± 1,126.51 pg/ml) was higher in patients with FL than that in the controls (477.16 ± 155.55 pg/ml; P < 0.001). No significant difference in the mean ± SD serum level of APRIL was found between patients and healthy controls (14.39 ± 43.33 vs 5.07 ± 2.52 ng/ml; P = 0.193). When the patients were divided into low- and high-BAFF and low- and high-APRIL groups based on the median value of the BAFF and APRIL serum levels (855.14 pg/ml and 6.35 ng/ml, respectively), a high APRIL, but not a high BAFF, serum level significantly correlated with low complete response rate to initial therapy, high relapse/progression rate, and inferior progression-free survival (PFS; P = 0.019) and overall survival (OS; P = 0.008) rates. A high APRIL serum level was also significantly associated with decreased PFS and OS in patients treated with non-rituximab regimens but not in patients treated with rituximab-containing regimens. The APRIL serum level remained an independent predictor for PFS and OS in multivariate analysis. APRIL may be an important prognostic predictor with potential significance as a therapeutic target in FL.
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, 410013, China.
authors.forename: Ya-Jun
authors.initials: YJ
authors.lastname: Li
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Li
authors.forename: Zhong-Jun
authors.initials: ZJ
authors.lastname: Xia
authors.forename: Su
authors.initials: S
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Xia
authors.forename: Hui-Qiang
authors.initials: HQ
authors.lastname: Huang
authors.forename: Jia-Jia
authors.initials: JJ
authors.lastname: Huang
authors.forename: Ping-Yong
authors.initials: PY
authors.lastname: Yi
authors.forename: Wen-Qi
authors.initials: WQ
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D053264:B-Cell Activating Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D053300:Tumor Necrosis Factor Ligand Superfamily Member 13 / Q000097:blood*
chemical_list: D053264:B-Cell Activating Factor; D015415:Biomarkers; C505719:TNFSF13B protein, human; D053300:Tumor Necrosis Factor Ligand Superfamily Member 13