title: The clinical significance of fibrinogen plasma levels in patients with diffuse large B cell lymphoma.
abstract: BACKGROUND
  Fibrinogen plays a crucial role in the pathophysiology of tumour cell growth, invasion and metastasis. The aim of this study was to evaluate the prognostic significance of pretreatment plasma fibrinogen levels in patients with diffuse large B cell lymphoma (DLBCL) METHODS: Data from 372 patients with DLBCL, diagnosed and treated between 2004 and 2013 at two Austrian centres, were evaluated retrospectively. The prognostic influences of plasma fibrinogen levels and other factors, including age, tumour stage and the National Comprehensive Cancer Network-International Prognostic Index, on 5-year overall survival (OS) and 5-year disease-free survival (DFS) were studied using Kaplan-Meier curves as well as univariate and multivariate Cox regression models.
  
  
  RESULTS
  Kaplan-Meier analysis revealed that a high fibrinogen plasma level is associated with decreased 5-year OS and 5-year DFS in patients with DLBCL (p<0.001, log-rank test). Furthermore, in multivariate analysis, elevated serum fibrinogen was found to be an independent marker of poor clinical outcome: 5-year OS (HR=1.69, 95% CI 1.06 to 2.72, p=0.029) and 5-year DFS (HR=1.68, 95% CI 1.08 to 2.61, p=0.021).
  
  
  CONCLUSIONS
  In the current study, we demonstrate that high plasma fibrinogen levels at diagnosis predict poor outcome in patients with DLBCL.
  
  
  BACKGROUND
  25-434 ex 12713 and 415-EP/73/127-2012.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: Katharina T
authors.initials: KT
authors.lastname: Troppan
authors.affiliation: 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Melchardt
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Wenzl
authors.affiliation: 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Schlick
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Deutsch
authors.affiliation: Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Marc D
authors.initials: MD
authors.lastname: Bullock
authors.affiliation: Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Reitz
authors.affiliation: Institute of Pathology, Medical University of Graz (MUG), Graz, Austria.
authors.forename: Christine
authors.initials: C
authors.lastname: Beham-Schmid
authors.affiliation: 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria.
authors.forename: Lukas
authors.initials: L
authors.lastname: Weiss
authors.affiliation: Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Neureiter
authors.affiliation: Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Tränkenschuh
authors.affiliation: 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria.
authors.forename: Richard
authors.initials: R
authors.lastname: Greil
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Neumeister
authors.affiliation: 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Egle
authors.affiliation: Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Pichler
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D005340:Fibrinogen / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D005340:Fibrinogen
keywords: HAEMATOLOGY; LYMPHOMA; MALIGNANT TUMOURS