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High APRIL but not BAFF serum levels are associated with poor outcome in patients with follicular lymphoma

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Abstract

Elevated B cell activation factor (BAFF) and a proliferation-inducing ligand (APRIL) serum levels have been reported to correlate with worse prognosis in B cell-derived malignancies. However, limited information exists regarding the prognostic significance of BAFF and APRIL serum levels in follicular lymphoma (FL). We measured BAFF and APRIL serum levels for 81 patients with newly diagnosed FL and 12 healthy controls. The mean ± standard deviation (SD) BAFF serum level (1,193.86 ± 1,126.51 pg/ml) was higher in patients with FL than that in the controls (477.16 ± 155.55 pg/ml; P < 0.001). No significant difference in the mean ± SD serum level of APRIL was found between patients and healthy controls (14.39 ± 43.33 vs 5.07 ± 2.52 ng/ml; P = 0.193). When the patients were divided into low- and high-BAFF and low- and high-APRIL groups based on the median value of the BAFF and APRIL serum levels (855.14 pg/ml and 6.35 ng/ml, respectively), a high APRIL, but not a high BAFF, serum level significantly correlated with low complete response rate to initial therapy, high relapse/progression rate, and inferior progression-free survival (PFS; P = 0.019) and overall survival (OS; P = 0.008) rates. A high APRIL serum level was also significantly associated with decreased PFS and OS in patients treated with non-rituximab regimens but not in patients treated with rituximab-containing regimens. The APRIL serum level remained an independent predictor for PFS and OS in multivariate analysis. APRIL may be an important prognostic predictor with potential significance as a therapeutic target in FL.

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Acknowledgments

This work was supported by the National Natural Scientific Research Fund of China (30400589 and 81071950), Key Projects in the National Science & Technology Pillar Program.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, 410013, China

    Ya-Jun Li & Ping-Yong Yi

  2. The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, 410013, China

    Ya-Jun Li & Ping-Yong Yi

  3. State Key Laboratory of Oncology in South China, 651 Dong Feng RD East, Guangzhou, 510060, China

    Zhi-Ming Li, Zhong-Jun Xia, Su Li, Yi Xia, Hui-Qiang Huang, Jia-Jia Huang & Wen-Qi Jiang

  4. Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China

    Zhi-Ming Li, Su Li, Yi Xia, Hui-Qiang Huang, Jia-Jia Huang & Wen-Qi Jiang

  5. Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China

    Zhong-Jun Xia

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  1. Ya-Jun Li
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Correspondence to Ping-Yong Yi or Wen-Qi Jiang.

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Ya-Jun Li and Zhi-Ming Li contributed equally to this work.

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Li, YJ., Li, ZM., Xia, ZJ. et al. High APRIL but not BAFF serum levels are associated with poor outcome in patients with follicular lymphoma. Ann Hematol 94, 79–88 (2015). https://doi.org/10.1007/s00277-014-2173-2

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  • DOI: https://doi.org/10.1007/s00277-014-2173-2

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