Prognostic value of lactate dehydrogenase, serum albumin and the lactate dehydrogenase/albumin ratio in patients with diffuse large B-cell lymphoma

Figures & data

Table 1. General clinical data of 212 patients with DLBCL.

Characteristics	n	Rate(%)
Age
<60years old	88	41.5
≥60years old	124	58.5
Sex
Male	104	49.1
Female	108	50.9
Symptoms
A	191	90.1
B	21	9.9
BMI
Normal(18.5-23.9)	108	50.9
Abnormal(<18.5 or >23.9)	104	49.1
Ann Arbor Staging
I ∼ II	97	45.8
III ∼ IV	115	54.2
GCB
yes	30	14.2
no	182	85.8
ECOG Scoring
ECOG(<2)	146	68.9
ECOG(≥2)	66	31.1
Number of extranodal sites
≥2	46	21.7
<2	166	78.3
HBV
yes	13	6.1
no	199	93.9
MONO
Mon(≤6.0)	160	75.5
Mon(>6.0)	52	24.5
WBC
WBC(<14)	199	93.9
WBC(≥14)	13	6.1
HGB
HGB(≤100)	35	16.5
HGB(>100)	177	83.5
BMI*
yes	22	10.4
no	190	89.6
IPI
IPI(<2)	94	44.3
IPI(≥2)	118	55.7

Figure 1. a. ROC curve of lactate dehydrogenase (LDH). b. ROC curve of albumin value (ALB).

Figure 2. Kaplan–Meier survival analysis of LDH. Overall survival (a) and progression-free survival (b) according to LDH in DLBCL patients.

Figure 3. Kaplan–Meier survival analysis of ALB. Overall survival (a) and progression-free survival (b) according to ALB in DLBCL patients.

Figure 4. ROC curve of the LAR.

Figure 5. Kaplan–Meier survival analysis of LAR. Overall survival (a) and progression-free survival (b) according to the LAR in DLBCL patients.

Table 2. Comparison of LDH and ALB in different clinicopathological features of DLBCL patients.

Characteristics	ALB (<38)	ALB (≥38)	P values	LDH (<301)	LDH (≥301)	P values
Age			0.009			0.185
<60 years old	33 (32.4%)	55 (50.0%)		67 (44.4%)	21 (34.4%)
≥60 years old	69 (67.6%)	55 (50.0%)		84 (55.6%)	40 (65.6%)
Sex			0.029			0.353
Male	58 (56.9%)	46 (41.8%)		71 (47.0%)	33 (54.1%)
Female	44 (43.1%)	64 (58.2%)		80 (53.0%)	28 (45.9%)
Symptoms			0.001			<0.001
A	85 (83.3%)	106 (96.4%)		145 (96.0%)	46 (75.4%)
B	17 (16.7%)	4 (3.6%)		6 (4.0%)	15 (24.6%)
BMI			0.168			0.377
normal	57 (55.9%)	51 (46.4%)		74 (49.0%)	34 (55.7%)
abnormal	45 (44.1%)	59 (53.6%)		77 (51.0%)	27 (44.3%)
Ann Arbor Staging			<0.001			<0.001
I ∼ II	33 (32.4%)	64 (58.2%)		81 (53.6%)	16 (26.2%)
III ∼ IV	69 (67.6%)	46 (41.8%)		70 (46.4%)	45 (73.8%)
GCB			0.865			0.784
yes	14 (13.7%)	16 (14.5%)		22 (14.6%)	8 (13.1%)
no	88 (86.3%)	94 (85.5%)		129 (85.4%)	53 (86.9%)
ECOG Scoring			0.713			0.742
ECOG(<2)	69 (67.6%)	77 (70.0%)		105 (69.5%)	41 (67.2%)
ECOG(≥2)	33 (32.4%)	33 (30.0%)		46 (30.5%)	20 (32.8%)
Number of extranodal sites ≥ 2			0.001			0.013
yes	32 (31.4%)	14 (12.7%)		26 (17.2%)	20 (32.8%)
no	70 (68.6%)	96 (87.3%)		125 (82.8%)	41 (67.2%)
Hepatitis B positive			0.117			0.155
yes	9 (8.8%)	4 (3.6%)		7 (4.6%)	6 (9.8%)
no	93 (91.2%)	106 (96.4%)		144 (95.4%)	55 (90.2%)
WBC			0.885			0.428
WBC(<14)	96 (94.1%)	103 (93.6%)		143 (94.7%)	56 (91.8%)
WBC(≥14)	6 (5.9%)	7 (6.4%)		8 (5.3%)	5 (8.2%)
MONO			0.343			<0.001
Mon(≤6.0)	74 (72.5%)	86 (78.2%)		127 (84.1%)	33 (54.1%)
Mon(＞6.0)	28 (27.5%)	24 (21.8%)		24 (15.9%)	28 (45.9%)
HGB			<0.001			0.001
HGB(≤100)	29 (28.4%)	6 (5.5%)		17 (11.3%)	18 (29.5%)
HGB(＞100)	73 (71.6%)	104 (94.5%)		134 (88.7%)	43 (70.5%)
BMI*			0.015			0.005
yes	16 (15.7%)	6 (5.5%)		10 (6.6%)	12 (19.7%)
no	86 (84.3%)	104 (94.5%)		141 (93.4%)	49 (80.3%)
IPI			<0.001			<0.001
IPI(<2)	31 (30.4%)	63 (57.3%)		86 (57.0%)	8 (13.1%)
IPI(≥2)	71 (69.6%)	47 (42.7%)		65 (43.0%)	53 (86.9%)
LDH/ALB			<0.001			<0.001
LAR(≥6)	76 (74.5%)	32 (29.1%)		47 (31.1%)	61 (100%)
LAR(<6)	26 (25.5%)	78 (70.9%)		104 (68.9%)	0 (0%)

Table 3. Univariate analysis of prognosis.

Influencing factors	OS		PFS
	HR (95% CI)	P values	HR (95% CI)	P values
Age (≥60 vs.<60)	0.870 (0.546-1.387)	0.559	0.833 (0.526-1.319)	0.435
Gender (Male vs.Female)	0.727 (0.467-1.132)	0.158	0.704 (0.450-1.101)	0.124
Symptoms (B vs.A)	0.701 (0.334-1.469)	0.346	0.733 (0.351-1.529)	0.408
Body mass index (normal vs.abnormal)	0.973 (0.621-1.524)	0.905	1.382 (0.882-2.165)	0.158
Staging (III /IV vs.I/II)	0.657 (0.410-1.054)	0.081	0.546 (0.341-0.874)	0.012
Generation Center B-cell (yes vs.no)	1.102 (0.616-1.973)	0.743	0.821 (0.465-1.448)	0.495
ECOG Scoring (≥2 vs.<2)	0.920 (0.583-1.454)	0.722	0.801 (0.508-1.264)	0.341
Number of extranodal sites (≥2 vs.<2)	0.564 (0.360-0.883)	0.012	0.364 (0.233-0.571)	<0.001
Hepatitis B positive (yes vs.no)	0.954 (0.384-2.367)	0.918	0.777 (0.312-1.932)	0.587
WBC (≥14 vs.<14)	0.697 (0.292-1.661)	0.415	0.608 (0.274-1.350)	0.221
Mono (≥6 vs.<6)	0.706 (0.443-1.127)	0.145	0.706 (0.443-1.127)	0.145
HGB (≤100 vs.>100)	0.315 (0.190-0.524)	<0.001	0.340 (0.206-0.564)	<0.001
BMI* (yes vs.no)	0.732 (0.376-1.424)	0.358	0.469 (0.239-0.921)	0.028
IPI (≥2 vs.<2)	0.551 (0.341-0.891)	0.015	0.468 (0.289-0.758)	0.002
ALB (<38 vs. ≥ 38)	0.386 (0.246-0.606)	<0.001	0.441 (0.280-0.692)	<0.001
LDH Value (≥301vs.<301)	0.449 (0.288-0.701)	<0.001	0.424 (0.272-0.660)	<0.001
LDH/ALB (≥6 vs.<6)	0.397 (0.249-0.631)	<0.001	0.430 (0.272-0.680)	<0.001

Table 4. Multivariate analysis of prognosis.

Influencing factors	OS		PFS
	HR (95% CI)	P values	HR (95% CI)	P values
HGB (normal vs.abnormal)	0.404 (0.230-0.710)	0.002	0.407 (0.241-0.688)	0.001
ALB (<38 vs. ≥ 38)	0.551 (0.382-0.926)	0.024	0.781 (0.471-1.295)	0.338
LDH Value (≥301 vs.<301)	0.899 (0.516-1.567)	0.707	0.679 (0.402-1.148)	0.148
Number of extranodal sites (≥2 vs.<2)	0.650 (0.407-1.040)	0.072	0.327 (0.193-0.555)	<0.001
IPI (≥2 vs.<2)	0.630 (0.373-1.066)	0.085	0.522 (0.283-0.964)	0.038
BMI* (yes vs.no)	-	-	1.085 (0.521-2.260)	0.827
Staging (III /IV vs.I/II)	-	-	1.061 (0.599-1.877)	0.840

Table 5. Multivariate analysis of prognosis.

Influencing factors	OS		PFS
	HR (95% CI)	P values	HR (95% CI)	P values
HGB (normal vs.abnormal)	0.407 (0.238-0.695)	0.001	0.406 (0.240-0.687)	0.001
LDH/ALB (≥6 vs.<6)	0.571 (0.344-0.948)	0.030	0.604 (0.373-0.979)	0.041
Number of extranodal sites (≥2 vs.<2)	0.583 (0.370-0.920)	0.020	0.299 (0.177-0.507)	<0.001
IPI (≥2 vs.<2)	0.634 (0.383-1.050)	0.077	0.463 (0.266-0.807)	0.007
BMI* (yes vs.no)	-	-	1.050 (0.505-2.183)	0.896
Staging (III /IV vs.I/II)	-	-	1.121 (0.645-1.947)	0.686

Table 6. Clinical data analysis of ALB and LDH.

Characteristics	ALB(<38)	ALB(≥38)	P values
LDH(<301)	16(26.2%)	94(62.3%)	<0.001
LDH(≥301)	45(73.8%)	57(37.7%)

Figure 6. Kaplan–Meier survival analysis of LDH + ALB. Overall survival (a) and progression-free survival (b) according to LDH + ALB in DLBCL patients.