High serum vascular endothelial growth factor level is an adverse prognostic factor for high-risk diffuse large B-cell lymphoma patients treated with dose-dense chemoimmunotherapy

Research output: Contribution to journalArticle


Objectives To determine whether serum vascular endothelial growth factor (s-VEGF) levels and VEGF gene expression in tumor tissue predict survival of diffuse large B-cell lymphoma (DLBCL) patients treated with chemoimmunotherapy. Methods VEGF levels were measured in serum samples from 102 patients <65yrs with high-risk DLBCL using a quantitative sandwich enzyme immunoassay technique. Exon array data set of tumor tissues from 32 patients was concurrently used to determine VEGF-A exon and gene expression. All patients were treated in a Nordic phase II study with six dose-dense chemoimmunotherapy courses followed by systemic central nervous system prophylaxis. Results After a median follow-up time of 40months, 3-yr progression-free survival (PFS) was inferior in patients with high s-VEGF levels compared to those with low levels (59% vs. 83%, P=0.005). The relative risk of progression or relapse was 3.1-fold (95% confidence interval 1.346.91, P=0.008). The predictive capacity of s-VEGF levels on PFS was most pronounced in the DLBCLs of non-germinal center subtype. In contrast to serum data, VEGF mRNA expression in the lymphoma tissue did not predict outcome, and no correlation was found between s-VEGF levels and lymphoma VEGF expression. Conclusion Pretreatment s-VEGF level is a predictor of PFS after chemoimmunotherapy and may help to further stratify high-risk DLBCL patients into low- and high-risk groups.


  • Sari Riihijarvi
  • Heidi Nurmi
  • Harald Holte
  • Magnus Bjorkholm
  • Oystein Fluge
  • Lars Moller Pedersen
  • Karin Fjordén
  • Mats Jerkeman
  • Mikael Eriksson
  • Sirpa Leppa
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology


  • diffuse large B-cell lymphoma, prognostic factors, vascular endothelial, growth factor, serum, ELISA, gene expression, exon array
Original languageEnglish
Pages (from-to)395-402
JournalEuropean Journal of Haematology
Issue number5
Publication statusPublished - 2012
Publication categoryResearch