Objectification of the method for glomerular filtration rate assessing in patients with diffuse large B-cell lymphoma during induction immunochemotherapy

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Abstract

Aim. To study the glomerular filtration rate (GFR) dynamics calculated by creatinine and cystatin C during induction immunochemotherapy in patients with newly diagnosed diffuse large B-cell lymphoma in order to objectify the method for estimation.

Materials and methods. The open longitudinal study included 39 patients with newly diagnosed diffuse large B-cell lymphoma who received specialized treatment at the Oncohematology Department of National Medical Research Centre for Oncology (Rostov-on-Don) in 2021. Patients received induction immunochemotherapy according to the R-CHOP regimen (rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisolone) in combination with accompanying therapy (allopurinol 300 mg/day). Blood sampling was carried out at 0, 24, 48, 72, 120 hours and on 21st day of the 1st therapy cycle. Patients were divided into 2 groups depending on the GFR level, calculated by creatinine, before treatment: group A – 27 (69 %) patients with GFR >90 ml/min/1.73 m2, group B – 12 (31 %) patients with GFR <90 ml/min/1.73 m2.

Results. During the immunochemotherapy in patients with initially reduced GFR, a further decrease was observed with the restoration of the initial level by day 21 of therapy. When calculating GFR by cystatin C, in contrast to the calculation by creatinine, it revealed the dependence of GFR level on pathological process stage: GFR in group A patients with stages I–II is 20.4 % lower than in patients with stages III–IV, in group B – by 30.5 %. The use of the fisher test at GFR thresholds of 90 and 60 ml/min/1.73 m2 revealed a greater advantage in establishing absolute GFR levels, especially in the range of 60 to 90 ml/min/1.73 m2.

Conclusion. The data obtained confirm that the determination of GFR by cystatin C in patients with diffuse large B-cell lymphoma is a more sensitive method that objectively reflects the functional state of the kidneys, especially when values are within the “gray area” – from 90 to 60 ml/min/1.73 m2.

About the authors

A. S. Nozdricheva

National Medical Research Centre for Oncology, Ministry of Health of Russia

Author for correspondence.
Email: anozdis@mail.ru
ORCID iD: 0000-0003-3336-9202

Anastasia S. Nozdricheva.

63 14th Liniya St., Rostov-on-Don 344037

Russian Federation

I. B. Lysenko

National Medical Research Centre for Oncology, Ministry of Health of Russia

ORCID iD: 0000-0003-4457-3815

63 14th Liniya St., Rostov-on-Don 344037

Russian Federation

N. K. Guskova

National Medical Research Centre for Oncology, Ministry of Health of Russia

ORCID iD: 0000-0002-4222-1579

63 14th Liniya St., Rostov-on-Don 344037

Russian Federation

N. V. Nikolaeva

National Medical Research Centre for Oncology, Ministry of Health of Russia

ORCID iD: 0000-0001-7224-3106

63 14th Liniya St., Rostov-on-Don 344037

Russian Federation

Ya. S. Gaysultanova

National Medical Research Centre for Oncology, Ministry of Health of Russia

ORCID iD: 0000-0003-2785-1721

63 14th Liniya St., Rostov-on-Don 344037

Russian Federation

S. N. Dimitriadi

National Medical Research Centre for Oncology, Ministry of Health of Russia

ORCID iD: 0000-0002-2565-1518

63 14th Liniya St., Rostov-on-Don 344037

Russian Federation

O. G. Ishonina

National Medical Research Centre for Oncology, Ministry of Health of Russia

ORCID iD: 0000-0002-5300-1213

63 14th Liniya St., Rostov-on-Don 344037

Russian Federation

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