Previous studies showed albumin at diagnosis could be used to predict outcome in patients with diffuse large B-cell lymphoma (DLBCL), but whether albumin could improve the international prognostic index (IPI) risk stratification remains unknown. Herein, we retrospectively analyzed 440 de novo DLBCL patients in this study. The cutoff value of albumin was 39.2 g/L. Patients with high serum albumin showed superior OS and PFS (p = 0.002 and p < 0.001, respectively). According to IPI, there were 163 patients (37.0%) in low-risk group, 107 (24.3%) in low-intermediate risk group, 114 (25.9%) in high-intermediate risk group and 56 (12.7%) in high-risk group. Further analysis showed high albumin could identify a subgroup of patients with extremely superior OS and PFS in low IPI risk patients (p = 0.022 and p = 0.034, respectively). Multivariate analysis revealed that high albumin was an independent prognostic factor for OS (relative ratio [RR] 0.122; 95% confidence interval [CI] 0.021-0.715, p = 0.020) and trend for PFS (RR 0.417; 95% CI 0.168-1.035, p = 0.059). In conclusion, our study suggests that albumin at diagnosis is a simple and effective prognostic factor in DLBCL patients, allowing the identification of a superior outcome subgroup in low-risk patients, which may help to guide treatment in clinical trial.

中文翻译：

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白蛋白改善了弥漫性大 B 细胞淋巴瘤低 IPI 风险患者的分层。

先前的研究表明，诊断时的白蛋白可用于预测弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者的预后，但白蛋白是否可以改善国际预后指数 (IPI) 风险分层仍然未知。在此，我们回顾性分析了本研究中的 440 名新发 DLBCL 患者。白蛋白的临界值为 39.2 g/L。血清白蛋白高的患者表现出优越的 OS 和 PFS（分别为 p = 0.002 和 p < 0.001）。根据IPI，低危组163例（37.0%），中低危组107例（24.3%），中高危组114例（25.9%），高危组56例（12.7%）风险组。进一步的分析表明，高白蛋白可以识别出在低 IPI 风险患者中具有极其优越的 OS 和 PFS 的患者亚组（分别为 p = 0.022 和 p = 0.034）。多变量分析显示，高白蛋白是 OS（相对比 [RR] 0.122；95% 置信区间 [CI] 0.021-0.715，p = 0.020）和 PFS 趋势（RR 0.417；95% CI 0.168-1.035）的独立预后因素, p = 0.059)。总之，我们的研究表明，诊断时的白蛋白是 DLBCL 患者的一种简单而有效的预后因素，可以在低风险患者中识别出更好的结果亚组，这可能有助于指导临床试验中的治疗。