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Presentation serum selenium predicts for overall survival, dose delivery, and first treatment response in aggressive non-hodgkin’s lymphoma

Presentation serum selenium predicts for overall survival, dose delivery, and first treatment response in aggressive non-hodgkin’s lymphoma
Presentation serum selenium predicts for overall survival, dose delivery, and first treatment response in aggressive non-hodgkin’s lymphoma
Purpose: This study was undertaken to test the hypothesis that serum selenium concentration at presentation correlates with dose delivery, first treatment response, and overall survival in patients with aggressive B-cell non-Hodgkin’s lymphoma.

Patients and Methods: The patients presented between July 1986 and March 1999 and received anthracycline-based chemotherapy, radiotherapy, or both. The total selenium content was retrospectively analyzed in 100 sera, frozen at presentation, using inductively coupled plasma mass spectrometry.

Results: The serum selenium concentration ranged from 0.33 to 1.51 mol/L (mean, 0.92 mol/L; United Kingdom adult reference range, 1.07 to 1.88 mol/L). Serum selenium concentration correlated closely with performance status but with no other clinical variable. Multivariate analysis revealed that increased dose delivery, summarized by an area under the curve, correlated positively with younger age (P < .001), advanced stage (P .001), and higher serum selenium concentration (P .032). Selenium level also correlated positively with response (odds ratio, 0.62; 95% confidence interval [CI], 0.43 to 0.90; P .011) and achievement of long-term remission after first treatment (log-rank test, 4.38; P .036). On multivariate analysis, selenium concentration was positively predictive of overall survival (hazard ratio [HR], 0.76 for 0.2 mol/L increase; 95% CI, 0.60 to 0.95; P .018), whereas age indicated negative borderline significance (HR, 1.09; 95% CI, 0.99 to 1.18; P .066).

Conclusion: Serum selenium concentration at presentation is a prognostic factor, predicting positively for dose delivery, treatment response, and long-term survival in aggressive non-Hodgkin’s lymphoma. Unlike most existing prognostic factors in aggressive non-Hodgkin’s lymphoma, selenium supplementation may offer a novel therapeutic strategy in this frequently curable malignancy.
1527-7755
2335-2341
Last, Kim W.
c5ca525b-d26d-4fee-889d-7c8ab8142ad7
Cornelius, V.
4b800ab8-820b-4681-ae6f-f52ef8852350
Delves, Trevor
7f09552c-85eb-472e-bc70-c4d53b1d9aa3
Sieniawska, Christine
1474f919-e115-4bef-afe8-f13556380bfe
Fitzgibbon, Jude
6afae538-ec1c-41a0-af2a-21b98dfbb356
Norton, Andrew
9a78b66b-d789-4f21-911c-09de3f2af25e
Amess, John
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Wilson, Andy
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Rohatiner, Ama J.S.
77d47b5d-22e6-4200-a566-dc4124f08c07
Lister, T. Andrew
6b42a014-ee50-4017-bbb8-16aa71b74018
Last, Kim W.
c5ca525b-d26d-4fee-889d-7c8ab8142ad7
Cornelius, V.
4b800ab8-820b-4681-ae6f-f52ef8852350
Delves, Trevor
7f09552c-85eb-472e-bc70-c4d53b1d9aa3
Sieniawska, Christine
1474f919-e115-4bef-afe8-f13556380bfe
Fitzgibbon, Jude
6afae538-ec1c-41a0-af2a-21b98dfbb356
Norton, Andrew
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Amess, John
a71b349f-7664-4786-b9c4-05c2b9fe4214
Wilson, Andy
f4f4c982-f2b9-4e99-9ec2-3b5b8f82973e
Rohatiner, Ama J.S.
77d47b5d-22e6-4200-a566-dc4124f08c07
Lister, T. Andrew
6b42a014-ee50-4017-bbb8-16aa71b74018

Last, Kim W., Cornelius, V., Delves, Trevor, Sieniawska, Christine, Fitzgibbon, Jude, Norton, Andrew, Amess, John, Wilson, Andy, Rohatiner, Ama J.S. and Lister, T. Andrew (2003) Presentation serum selenium predicts for overall survival, dose delivery, and first treatment response in aggressive non-hodgkin’s lymphoma. Journal of Clinical Oncology, 21 (12), 2335-2341. (doi:10.1200/JCO.2003.06.145).

Record type: Article

Abstract

Purpose: This study was undertaken to test the hypothesis that serum selenium concentration at presentation correlates with dose delivery, first treatment response, and overall survival in patients with aggressive B-cell non-Hodgkin’s lymphoma.

Patients and Methods: The patients presented between July 1986 and March 1999 and received anthracycline-based chemotherapy, radiotherapy, or both. The total selenium content was retrospectively analyzed in 100 sera, frozen at presentation, using inductively coupled plasma mass spectrometry.

Results: The serum selenium concentration ranged from 0.33 to 1.51 mol/L (mean, 0.92 mol/L; United Kingdom adult reference range, 1.07 to 1.88 mol/L). Serum selenium concentration correlated closely with performance status but with no other clinical variable. Multivariate analysis revealed that increased dose delivery, summarized by an area under the curve, correlated positively with younger age (P < .001), advanced stage (P .001), and higher serum selenium concentration (P .032). Selenium level also correlated positively with response (odds ratio, 0.62; 95% confidence interval [CI], 0.43 to 0.90; P .011) and achievement of long-term remission after first treatment (log-rank test, 4.38; P .036). On multivariate analysis, selenium concentration was positively predictive of overall survival (hazard ratio [HR], 0.76 for 0.2 mol/L increase; 95% CI, 0.60 to 0.95; P .018), whereas age indicated negative borderline significance (HR, 1.09; 95% CI, 0.99 to 1.18; P .066).

Conclusion: Serum selenium concentration at presentation is a prognostic factor, predicting positively for dose delivery, treatment response, and long-term survival in aggressive non-Hodgkin’s lymphoma. Unlike most existing prognostic factors in aggressive non-Hodgkin’s lymphoma, selenium supplementation may offer a novel therapeutic strategy in this frequently curable malignancy.

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Published date: 15 June 2003

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Local EPrints ID: 162323
URI: http://eprints.soton.ac.uk/id/eprint/162323
ISSN: 1527-7755
PURE UUID: 5d0fd91a-13a2-482a-bd85-e2ccd16d0762

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Date deposited: 18 Aug 2010 13:03
Last modified: 08 Jan 2022 17:28

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Contributors

Author: Kim W. Last
Author: V. Cornelius
Author: Trevor Delves
Author: Christine Sieniawska
Author: Jude Fitzgibbon
Author: Andrew Norton
Author: John Amess
Author: Andy Wilson
Author: Ama J.S. Rohatiner
Author: T. Andrew Lister

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