Background: Mortalin, a mitochondrial heat shock protein 70 family member encoded by the HSPA9 gene, may be associated with resistance to rituximab immunotherapy and lower survival rates. The aim of the study was to assess the potential of baseline mortalin and positron emission tomography/computed tomography (PET/CT) parameters in predicting the prognosis of diffuse large B-cell lymphoma (DLBCL) patients after treatment with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Methods: The study retrospectively analyzed the clinical data of 83 patients diagnosed with DLBCL who underwent R-CHOP. The baseline mortalin data, together with PET/CT parameters, were evaluated. Receiver operating characteristic (ROC) curve analysis, along with univariate and multivariate Cox regression, was performed to determine the independent prognostic parameters affecting survival in DLBCL patients. A nomogram based on the parameters was constructed and validated. Results: In univariate analyses, Ann Arbor stage, mortalin, D max , metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were significantly correlated with progression-free survival (PFS), among which D max was also significantly correlated with overall survival (OS). Multivariate Cox regression analysis showed that mortalin (hazard ratio HR = 5.41, 95% confidence interval CI = 1.13–25.95, P = 0.035) and MTV (HR = 109.91, 95% CI = 3.82–3162.82, P = 0.006) were independent risk factors for PFS. A nomogram prediction model based on mortalin and MTV showed good risk stratification ability for PFS in DLBCL patients treated with R-CHOP. Conclusion: Both baseline mortalin and PET/CT MTV parameters were found to be significantly correlated with PFS in DLBCL patients treated with R-CHOP. Mortalin could be included in routine pathological examination items in the future.
Liu et al. (Wed,) studied this question.