Low Serum Apolipoprotein A1 Level Predicts Poor Prognosis of Patients with Diffuse Large B-cell Lymphoma in the Real World: a Retrospective Study

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2024 Jan 11

PMID 38212711

Authors

Xiaoling Huang

Ying Wang

Zhenyu Huang

Xuzheng Chen

Qiuyan Lin

Haobo Huang

Liping Fan

Affiliations

Soon will be listed here.

Abstract

Background: Apolipoprotein A1 (ApoA1) is a member of the apolipoprotein family with diverse functions. It is associated with the pathogenesis and prognosis of several types of tumors. However, the role of serum apolipoprotein A1 (ApoA1) in the prognosis of patients with diffuse large B-cell lymphoma (DLBCL) remains unclear. This study aimed to elucidate its influence on clinical outcomes in patients with DLBCL.

Methods: We retrospectively analyzed a cohort of 1583 consecutive DLBCL patients admitted to the Fujian Medical University Union Hospital between January 2011 and December 2021. 949 newly diagnosed DLBCL patients who met the inclusion criteria were enrolled for statistical analysis. Receiver operating characteristic curve analysis was performed to determine the optimal cut-off value for serum ApoA1 levels for prognostic prediction among patients with DLBCL. The correlations between serum ApoA1 levels and clinical and laboratory parameters were analyzed. Prognostic significance was analyzed using univariate and multivariate Cox proportional hazards models.

Results: Newly diagnosed patients with DLBCL demonstrated low serum ApoA1 levels (< 0.925 g/L), had more B symptoms, higher levels of serum lactate dehydrogenase (LDH) (>upper limit of normal), poorer performance status (Eastern Cooperative Oncology Group score of 2-4), higher percentage of advanced stage and non-germinal center B-cell (non-GCB) subtype, more cases of > 1 extranodal site, higher International Prognostic Index (IPI) score (3-5), and higher incidence of relapse or refractory diseases compared with those with high serum ApoA1 levels (≥ 0.925 g/L). Low serum ApoA1 levels were an independent adverse prognostic factor for overall survival (OS) but not progression-free survival (PFS).

Conclusions: Low serum ApoA1 levels were associated with poor treatment response and inferior survival in newly diagnosed patients with DLBCL.

Citing Articles

Tumor Biology Hides Novel Therapeutic Approaches to Diffuse Large B-Cell Lymphoma: A Narrative Review.

Masnikosa R, Cvetkovic Z, Piric D Int J Mol Sci. 2024; 25(21).

PMID: 39518937 PMC: 11545713. DOI: 10.3390/ijms252111384.

References

Crump M, Neelapu S, Farooq U, Van den Neste E, Kuruvilla J, Westin J . Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. Blood. 2017; 130(16):1800-1808. PMC: 5649550. DOI: 10.1182/blood-2017-03-769620. View

Ayers E, Li S, Medeiros L, Bond D, Maddocks K, Torka P . Outcomes in patients with aggressive B-cell non-Hodgkin lymphoma after intensive frontline treatment failure. Cancer. 2019; 126(2):293-303. DOI: 10.1002/cncr.32526. View

Risueno A, Hagner P, Towfic F, Fontanillo C, Djebbari A, Parker J . Leveraging gene expression subgroups to classify DLBCL patients and select for clinical benefit from a novel agent. Blood. 2020; 135(13):1008-1018. PMC: 7099333. DOI: 10.1182/blood.2019002414. View

Gumilas N, Harini I, Ernawati D, Indriani V, Novrial D, Kurniawan D . Potential of Apolipoprotein A1 (ApoA1) for Detecting Liver Cirrhosis and Hepatocellular Carcinoma. Asian Pac J Cancer Prev. 2022; 23(6):2001-2008. PMC: 9587809. DOI: 10.31557/APJCP.2022.23.6.2001. View

Yu T, Luo D, Luo C, Xu-Monette Z, Yu L . Prognostic and therapeutic value of serum lipids and a new IPI score system based on apolipoprotein A-I in diffuse large B-cell lymphoma. Am J Cancer Res. 2023; 13(2):475-484. PMC: 9989605. View

Ruppert A, Dixon J, Salles G, Wall A, Cunningham D, Poeschel V . International prognostic indices in diffuse large B-cell lymphoma: a comparison of IPI, R-IPI, and NCCN-IPI. Blood. 2020; 135(23):2041-2048. DOI: 10.1182/blood.2019002729. View

Cheson B, Pfistner B, Juweid M, Gascoyne R, Specht L, Horning S . Revised response criteria for malignant lymphoma. J Clin Oncol. 2007; 25(5):579-86. DOI: 10.1200/JCO.2006.09.2403. View

Zelenetz A, Wierda W, Abramson J, Advani R, Andreadis C, Bartlett N . Non-Hodgkin's lymphomas, version 1.2013. J Natl Compr Canc Netw. 2013; 11(3):257-72. DOI: 10.6004/jnccn.2013.0037. View

Iwamoto H, Abe M, Yang Y, Cui D, Seki T, Nakamura M . Cancer Lipid Metabolism Confers Antiangiogenic Drug Resistance. Cell Metab. 2018; 28(1):104-117.e5. DOI: 10.1016/j.cmet.2018.05.005. View

10.

Borgquist S, Butt T, Almgren P, Shiffman D, Stocks T, Orho-Melander M . Apolipoproteins, lipids and risk of cancer. Int J Cancer. 2016; 138(11):2648-56. DOI: 10.1002/ijc.30013. View

11.

Liu F, Zhang X, Wu F, Peng H . Hsa_circ_0088212-mediated miR-520 h/APOA1 axis inhibits osteosarcoma progression. Transl Oncol. 2021; 14(12):101219. PMC: 8461379. DOI: 10.1016/j.tranon.2021.101219. View

12.

Shi Y, Han Y, Yang J, Liu P, He X, Zhang C . Clinical features and outcomes of diffuse large B-cell lymphoma based on nodal or extranodal primary sites of origin: Analysis of 1,085 WHO classified cases in a single institution in China. Chin J Cancer Res. 2019; 31(1):152-161. PMC: 6433587. DOI: 10.21147/j.issn.1000-9604.2019.01.10. View

13.

Oberle R, Kuhrer K, Osterreicher T, Weber F, Steinbauer S, Udonta F . The HDL particle composition determines its antitumor activity in pancreatic cancer. Life Sci Alliance. 2022; 5(9). PMC: 9112193. DOI: 10.26508/lsa.202101317. View

14.

Li J, Zhang S, Chen S, Yuan Y, Zuo M, Li T . Lipid metabolism-related gene signature predicts prognosis and depicts tumor microenvironment immune landscape in gliomas. Front Immunol. 2023; 14:1021678. PMC: 9968762. DOI: 10.3389/fimmu.2023.1021678. View

15.

Sun Y, Ren D, Yang C, Yang W, Zhao J, Zhou Y . TRIM15 promotes the invasion and metastasis of pancreatic cancer cells by mediating APOA1 ubiquitination and degradation. Biochim Biophys Acta Mol Basis Dis. 2021; 1867(11):166213. DOI: 10.1016/j.bbadis.2021.166213. View

16.

Cherng H, Westin J . Why R-CHOP + X is not enough: lessons learned and next steps in the mission to improve frontline therapy for diffuse large B-cell lymphoma. Leuk Lymphoma. 2021; 62(6):1302-1312. PMC: 9153122. DOI: 10.1080/10428194.2020.1869228. View

17.

Cine N, Baykal A, Sunnetci D, Canturk Z, Serhatli M, Savli H . Identification of ApoA1, HPX and POTEE genes by omic analysis in breast cancer. Oncol Rep. 2014; 32(3):1078-86. DOI: 10.3892/or.2014.3277. View

18.

Cioce M, Canino C, Pass H, Blandino G, Strano S, Fazio V . Arachidonic acid drives adaptive responses to chemotherapy-induced stress in malignant mesothelioma. J Exp Clin Cancer Res. 2021; 40(1):344. PMC: 8561918. DOI: 10.1186/s13046-021-02118-y. View

19.

Lin C, Huang R, Lu T, Kuo K, Lo K, Chen C . High prevalence of APOA1/C3/A4/A5 alterations in luminal breast cancers among young women in East Asia. NPJ Breast Cancer. 2021; 7(1):88. PMC: 8257799. DOI: 10.1038/s41523-021-00299-5. View

20.

Wang F, Lu L, Chen H, Yue Y, Sun Y, Yan F . Altered serum lipid levels are associated with prognosis of diffuse large B cell lymphoma and influenced by utility of rituximab. Ann Hematol. 2023; 102(2):393-402. DOI: 10.1007/s00277-023-05092-x. View