Plasma Fibrinogen Levels Prognostic in DLBCL?

October 5, 2018
Leah Lawrence
Leah Lawrence

Plasma fibrinogen tests should be encouraged routinely in clinical practice to clarify its predictive benefit, according to a study.

Although elevated levels of plasma fibrinogen did not have prognostic significance in patients with diffuse large B-cell lymphoma (DLBCL), they were linked with several clinical features and laboratory parameters, according to a study published in Hematology.

These results suggest “the possible prognostic utility of baseline fibrinogen concentration,” according to Amira Mohamed Foad Shehata, of Menoufia University, Egypt, and colleagues.

Fibrinogen plays a critical role in maintenance of hemostasis, inflammatory responses, and neoplastic regression, according to the study, and has been associated with progression and metastasis of other cancer types in previous research.

In an attempt to identify an inexpensive and widely available prognostic marker for DLBCL, Shehata and colleagues studied 76 patients with DLBCL to see if baseline plasma fibrinogen levels correlated with clinical features, response to treatment, or outcomes.

All patients were treated with rituximab plus cyclophosphamide, vincristine, doxorubicin, and hostacortine at a single center between August 2015 and February 2018. At baseline, 56.6% of patients had fibrinogen levels below 400 mg/dL and 43.4% had levels above 400 mg/dL. During follow-up, 56 patients experienced partial or complete response.

Baseline fibrinogen was not associated with the number of extranodal sites, performance status, International prognostic index, or response to treatment. However, fibrinogen was associated with B symptoms and clinical stage (P < .001 for both).

Additionally, fibrinogen levels were associated with red cell distribution width (P < .001), platelet count (P = .02), serum lactate dehydrogenase (P = .009), and B2-microglobulin (P = .008).

Survival outcomes were not associated with baseline fibrinogen levels. Overall and progression-free survival was not significantly different for patients with hyperfibrinogenemia and those without.

“Our study reported important associations between fibrinogen levels and various clinical and laboratory parameters. The inclusion of baseline plasma fibrinogen as routine laboratory test and its integration in the prognostic scores for DLBCL patients may prove its utility as valuable predictive biomarker,” the researchers wrote.