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Risk stratification model based on VEGF and International Prognostic Index accurately identifies low-risk diffuse large B-cell lymphoma patients in the rituximab era

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Abstract

Vascular endothelial growth factor affects the invasiveness of solid tumors by regulating angiogenesis. However, it is not clear whether VEGF could be used to predict the prognosis of DLBCL in the era of rituximab-based immunotherapy. We conducted a retrospective study to explore response to therapy and the prognostic value of VEGF on DLBCL in the rituximab era. The subjects were 65 patients with a histological diagnosis of DLBCL from the Affiliated Hospital of Xuzhou Medical University. Kaplan–Meier analysis was performed to estimate the cumulative survival rate of patients with different VEGF and IPI levels, and comparisons between groups were made using the log-rank test. DLBCL patients with elevated VEGF were more likely to have extranodal involvement, advanced stage, Myc/Bcl-2 double expression, and a higher Ki-67 score. Elevated VEGF was associated with poor therapeutic response and survival. When patients were divided into low, low-intermediate, high-intermediate and high-risk groups using the V-IPI model based on VEGF and IPI, PFS rates were 94.4, 74.1, 40.6 and 14.8%, respectively. This model better identified low-risk patients than IPI (85.9, 88.9, 37 and 7.8%). Our results demonstrate that VEGF predicts therapeutic response in DLBCL and the V-IPI model accurately predicts PFS of low-risk DLBCL in the rituximab era.

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Acknowledgements

We would like to thank Dr. Mingzhi Zhang for assisting with manuscript editing. We also thank Dr. Hui Liu and Dr. Guangzhen Liu for their assistance in confirming the pathological results.

Funding

This work was supported by Natural Science Foundation of Jiangsu Province [Grant/Award Number: BK20171181]; Jiangsu Key Research and Development Project of Social Development [Grant/Award Number: BE2019638]; Young Medical Talents of Jiangsu Science and Education Health Project [Grant/Award Number: QNRC2016791].

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Authors and Affiliations

  1. Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, Jiangsu, China

    Wei Sang, Hang Zhou, Yuanyuan Qin, Dongmei Yan, Cai Sun, Xuguang Song, Yuhan Ma, Dongyun Tu, Zhenzhen Bian, Shanlin Nie, Linyan Xu, Zhenyu Li & Kailin Xu

  2. Department of Epidemiology and Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China

    Ziyuan Shen & Yingliang Jin

Authors
  1. Wei Sang
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  2. Hang Zhou
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  3. Yuanyuan Qin
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  4. Ziyuan Shen
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Contributions

KLX and WS conceived this study. HZ, YYQ and ZYS did most of the data analysis. HZ, YYQ, DMY, XGS, CS, YHM, SLN and ZZB collected patients’data. ZYL, LYX and YLJ provided the advices of this study. All authors discussed the results, explained them further and prepared the tables and panels for these figures. WS, HZ and ZYS wrote the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kailin Xu.

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Sang, W., Zhou, H., Qin, Y. et al. Risk stratification model based on VEGF and International Prognostic Index accurately identifies low-risk diffuse large B-cell lymphoma patients in the rituximab era. Int J Hematol 114, 189–198 (2021). https://doi.org/10.1007/s12185-021-03145-3

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  • DOI: https://doi.org/10.1007/s12185-021-03145-3

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