DLBCL: lymphoma-related hypercalcemia linked to inferior survival

  • Abadi U & al.
  • Leuk Lymphoma
  • 6 Jun 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), hypercalcemia with low parathyroid hormone (PTH) level was linked to inferior survival.

Why this matters

  • Hypercalcemia has been associated with poor prognosis in patients with cancer and can be primary hyperparathyroidism-related (PHPT) or lymphoma-related.

Study design

  • Study to investigate prevalence of hypercalcemia in patients with newly diagnosed DLBCL and to compare clinical characteristics and outcomes in patients with vs without lymphoma-associated hypercalcemia.
  • Funding: None disclosed.

Key results

  • Data were sourced for 250 patients treated at 2 academic medical centers, among whom 46 (18%) presented with hypercalcemia; these were matched with 46 age- and sex-matched DLBCL control patients with normal calcium levels from a centralized database.
  • Among patients with hypercalcemia vs control patients:
    • Higher percentage of patients with Ann Arbor stage III-IV (P=.03).
    • Higher lactate dehydrogenase levels (LDH; P<.001>
    • Higher albumin levels (P<.0001>
    • Response and survival outcomes were comparable.
  • When comparing patients with PHPT-related vs lymphoma-related hypercalcemia, patients with lymphoma-related hypercalcemia had:
    • More advanced stage disease (P=.004).
    • Higher LDH levels (P=.001).
    • Lower albumin levels (P=.004).
    • Significantly inferior OS (P=.016).
    • Significantly inferior PFS (P=.016).

Limitations

  • Retrospective data.