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Erschienen in:

03.02.2023 | Original Article

Low T3 syndrome as a predictor of poor outcomes in patients with follicular lymphoma

verfasst von: Lian-Guo Xue, Hao-Rui Shen, Rui Gao, Kai-Xin Du, Tong-Yao Xing, Wei-Ting Wang, Li Wang, Jian-Yong Li, Jin-Hua Liang, Wei Xu

Erschienen in: Annals of Hematology | Ausgabe 4/2023

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Abstract

The aim of this study was to investigate the prognostic value of low T3 syndrome in follicular lymphoma (FL). A total of 221 FL patients with detailed serum thyroid hormone levels and other complete clinical data were enrolled. Baseline features associated with low T3 syndrome were analyzed and balanced by propensity score matching. Univariate and multivariate regression analyses were performed to determine independent risk factors for progression-free survival (PFS) and overall survival (OS). A receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to assess the predictive accuracy of FL international prognostic index FLIPI-1/FLIPI-2 and low T3 syndrome. A total of 22 patients (10.0%) had low T3 syndrome at diagnosis, which was associated with poor PFS and OS in the rituximab era. It is an independent prognostic factor for PFS and OS. Low T3 syndrome and FLIPI-1/FLIPI-2 significantly increased the AUC of PFS and OS compared to FLIPI-1/FLIPI-2 alone. Low T3 is a risk factor for POD24. In conclusion, low T3 syndrome may be a good candidate for predicting the prognosis of CLL in future clinical practice. Our study demonstrates that low T3 syndrome is associated with poorer survival outcomes in FL patients.

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Freedman A, Jacobsen E (2020) Follicular lymphoma: 2020 update on diagnosis and management. Am J Hematol J Artic; Rev 95(3):316–27CrossRef

Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R et al (2016) The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood J Artic; Rev; Res Support, N.I.H., Extramural; Res Support, Non-U S Gov’t] 127(20):2375–90

Kridel R, Sehn LH, Gascoyne RD (2012) Pathogenesis of follicular lymphoma. J Clin Invest J Artic; Res Support, Non-U S Gov’t; Rev 122(10):3424–31

Kumagai S, Tashima M, Fujikawa J, Iwasaki M, Iwamoto Y, Sueki Y et al (2014) Ratio of peripheral blood absolute lymphocyte count to absolute monocyte count at diagnosis is associated with progression-free survival in follicular lymphoma. Int J Hematol J Artic 99(6):737–42CrossRef

Casulo C (2021) Upfront identification of high-risk follicular lymphoma. Hematol Oncol J Artic; Rev 39 Suppl 1(1):88–93CrossRef

Solal-Celigny P, Roy P, Colombat P, White J, Armitage JO, Arranz-Saez R et al (2004) Follicular lymphoma international prognostic index. Blood J Artic; Res Support, Non-U S Gov’t 104(5):1258–65

Federico M, Bellei M, Marcheselli L, Luminari S, Lopez-Guillermo A, Vitolo U et al (2009) Follicular lymphoma international prognostic index 2: a new prognostic index for follicular lymphoma developed by the international follicular lymphoma prognostic factor project. J Clin Oncol J Artic; Res Support, Non-U S Gov’t 27(27):4555–62

Gilani N, Wang K, Muncan A, Peter J, An S, Bhatti S et al (2021) Triiodothyronine maintains cardiac transverse-tubule structure and function. J Mol Cell Cardiol J Artic; Res Support, N I H, Extramural 160:1–14CrossRef

Pingitore A, Mastorci F, Piaggi P, Aquaro GD, Molinaro S, Ravani M et al (2019) Usefulness of triiodothyronine replacement therapy in patients with ST elevation myocardial infarction and borderline/reduced triiodothyronine levels (from the THIRST Study). Am J Cardiol J Artic; Randomized Control Trial 123(6):905–12

10.

Razvi S, Jabbar A, Pingitore A, Danzi S, Biondi B, Klein I et al (2018) Thyroid hormones and cardiovascular function and diseases. J Am Coll Cardiol J Artic; Rev 71(16):1781–96CrossRef

11.

Su W, Zhao XQ, Wang M, Chen H, Li HW (2018) Low T3 syndrome improves risk prediction of in-hospital cardiovascular death in patients with acute myocardial infarction. J Cardiol Eval Study; J Artic; Res Support, Non-U S Gov’t] 72(3):215–9

12.

Sato Y, Yoshihisa A, Kimishima Y, Kiko T, Kanno Y, Yokokawa T et al (2019) Low T3 syndrome is associated with high mortality in hospitalized patients with heart failure. J Card Fail 25(3):195–203CrossRefPubMed

13.

Liu J, Wu X, Lu F, Zhao L, Shi L, Xu F (2016) Low T3 syndrome is a strong predictor of poor outcomes in patients with community-acquired pneumonia. Sci Rep 6(1):22271

14.

Xu J, Wang L (2019) Low T3 syndrome as a predictor of poor prognosis in patients with pyogenic liver abscess. Front Endocrinol 10:541

15.

Inaba M, Mori K, Tsujimoto Y, Yamada S, Yamazaki Y, Emoto M et al (2021) Association of reduced free T3 to free T4 ratio with lower serum creatinine in Japanese hemodialysis patients. Nutrients 13(12):4537CrossRefPubMedCentralPubMed

16.

Qiao S, Zhang SC, Zhang RR, Wang L, Wang ZH, Jiang J et al (2022) Thyroid function and low free triiodothyronine in Chinese patients with autoimmune encephalitis. Front Immunol J Artic; Res Support, Non-U S Gov’t 13:821746

17.

Bunevicius A, Deltuva V, Tamasauskas S, Tamasauskas A, Laws EJ, Bunevicius R (2013) Low triiodothyronine syndrome as a predictor of poor outcomes in patients undergoing brain tumor surgery: a pilot study: clinical article. J Neurosurg J Artic; Res Support, Non-U S Gov’t 118(6):1279–87

18.

Huang G, Zeng Y, Cheng Q, Cheng H, Ruan Y, Yuan C et al (2019) Low triiodothyronine syndrome is associated with hemorrhagic transformation in patients with acute ischaemic stroke. Aging (Albany, NY) 11(16):6385–97CrossRefPubMed

19.

Chen M, Zhou W, Xu W (2021) Thyroid function analysis in 50 patients with COVID-19: a retrospective study. Thyroid J Article; Res Support, Non-U S Gov’t 31(1):8–11

20.

Sciacchitano S, De Vitis C, D’Ascanio M, Giovagnoli S, De Dominicis C, Laghi A et al (2021) Gene signature and immune cell profiling by high-dimensional, single-cell analysis in COVID-19 patients, presenting Low T3 syndrome and coexistent hematological malignancies. J Transl Med J Artic; Res Support, Non-U S Gov’t 19(1):139

21.

Mohn A, Di Marzio A, Cerruto M, Angrilli F, Fioritoni C, Chiarelli F (2001) Euthyroid sick syndrome in children with Hodgkin disease. Pediatr Hematol Oncol J Artic 18(3):211–5CrossRef

22.

Gao R, Chen RZ, Xia Y, Liang JH, Wang L, Zhu HY et al (2018) Low T3 syndrome as a predictor of poor prognosis in chronic lymphocytic leukemia. Int J Cancer J Artic; Res Support, Non-U S Gov’t 143(3):466–77

23.

Gao R, Liang J, Wang L, Zhu H, Wu W, Wu J et al (2017) Low T3 syndrome is a strong prognostic predictor in diffuse large B cell lymphoma. Brit J Haematol 177(1):95–105CrossRef

24.

Meignan M, Cottereau AS, Versari A, Chartier L, Dupuis J, Boussetta S et al (2016) Baseline metabolic tumor volume predicts outcome in high-tumor-burden follicular lymphoma: a pooled analysis of three multicenter studies. J Clin Oncol J Artic 34(30):3618–26CrossRef

25.

Sabattini E, Bacci F, Sagramoso C, Pileri SA (2010) WHO classification of tumours of haematopoietic and lymphoid tissues in 2008: an overview. Pathologica Editorial 102(3):83–7

26.

Plikat K, Langgartner J, Buettner R, Bollheimer LC, Woenckhaus U, Scholmerich J et al (2007) Frequency and outcome of patients with nonthyroidal illness syndrome in a medical intensive care unit. Metab Clin Trial; J Artic 56(2):239–44

27.

Liu S, Ren J, Zhao Y, Han G, Hong Z, Yan D et al (2013) Nonthyroidal illness syndrome: is it far away from Crohn’s disease? J Clin Gastrolenterol Comp Study; J Artic; Res Support, Non-U S Gov’t 47(2):153–9

28.

Utiger RD (1995) Altered thyroid function in nonthyroidal illness and surgery. To treat or not to treat? N Engl J Med Comment; Editorial 333(23):1562–3CrossRef

29.

Iltumur K, Olmez G, Ariturk Z, Taskesen T, Toprak N (2005) Clinical investigation: thyroid function test abnormalities in cardiac arrest associated with acute coronary syndrome. Crit Care Compa Study; Control Clin Trial; J Artic 9(4):R416-24

30.

Boelaert K (2013) Thyroid dysfunction in the elderly. Nat Rev Endocrinol J Artic; Rev 9(4):194–204CrossRef

31.

Tognini S, Marchini F, Dardano A, Polini A, Ferdeghini M, Castiglioni M et al (2010) Non-thyroidal illness syndrome and short-term survival in a hospitalised older population. Age Ageing J Artic; Res Support, Non-U S Gov’t] 39(1):46–50

32.

Bertoli A, Valentini A, Cianfarani MA, Gasbarra E, Tarantino U, Federici M (2017) Low FT3: a possible marker of frailty in the elderly. Clin Interv Aging J Arti; Observational Study 12:335–41CrossRef

33.

Yasar ZA, Kirakli C, Yilmaz U, Ucar ZZ, Talay F (2014) Can non-thyroid illness syndrome predict mortality in lung cancer patients? A prospective cohort study. Horm Cancer J Artic 5(4):240–6CrossRef

34.

Huang J, Jin L, Ji G, Xing L, Xu C, Xiong X et al (2013) Implication from thyroid function decreasing during chemotherapy in breast cancer patients: chemosensitization role of triiodothyronine. BMC Cancer J Artic 13:334CrossRef

35.

Sarkozy C, Maurer MJ, Link BK, Ghesquieres H, Nicolas E, Thompson CA et al (2019) Cause of death in follicular lymphoma in the first decade of the rituximab era: a pooled analysis of French and US cohorts. J Clin Oncol J Arti; Res Support, N I H, Extramural 37(2):144–52

36.

Pingitore A, Landi P, Taddei MC, Ripoli A, L Abbate A, Iervasi G (2005) Triiodothyronine levels for risk stratification of patients with chronic heart failure. Am J Med 118(2):132–6CrossRefPubMed

37.

Fan J, Yan P, Wang Y, Shen B, Ding F, Liu Y (2016) Prevalence and clinical significance of low T3 syndrome in non-dialysis patients with chronic kidney disease. Med Sci Monit J Artic; Res Support, Non-U S Gov’t 22:1171–9

38.

Galli E, Pingitore A, Iervasi G (2010) The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence. Heart Fail Rev J Artic; Rev 15(2):155–69CrossRef

39.

Wajner SM, Goemann IM, Bueno AL, Larsen PR, Maia AL (2011) IL-6 promotes nonthyroidal illness syndrome by blocking thyroxine activation while promoting thyroid hormone inactivation in human cells. J Clin Invest J Artic; Res Support, N I H, Extramural; Res Support, Non-U S Gov’t 121(5):1834–45

40.

McMillan DC (2009) Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care J Artic; R Support, Non-U S Gov’t; Rev 12(3):223–6CrossRef

41.

Bello G, Pennisi MA, Montini L, Silva S, Maviglia R, Cavallaro F et al (2009) Nonthyroidal illness syndrome and prolonged mechanical ventilation in patients admitted to the ICU. Chest J Art 135(6):1448–54CrossRef

42.

Casulo C, Dixon JG, Le-Rademacher J, Hoster E, Hochster HS, Hiddemann W et al (2022) Validation of POD24 as a robust early clinical end point of poor survival in FL from 5225 patients on 13 clinical trials. Blood J Artic; Res Support, Non-U S Gov’t 139(11):1684–93

Titel: Low T3 syndrome as a predictor of poor outcomes in patients with follicular lymphoma
verfasst von: Lian-Guo Xue
Hao-Rui Shen
Rui Gao
Kai-Xin Du
Tong-Yao Xing
Wei-Ting Wang
Li Wang
Jian-Yong Li
Jin-Hua Liang
Wei Xu
Publikationsdatum: 03.02.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Annals of Hematology / Ausgabe 4/2023
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-023-05117-5

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