Prognostic significance of elevated D-dimer level in classical Hodgkin's Lymphoma

BACKGROUND: Hodgkin lymphoma (HL) is an aggressive B-cell lymphoma, considered one of the most curable hematological malignancies. Hasenclever International Prognostic Score was designed to predict 5-year freedom from the progression of HL. D-dimer is a fibrin degradation element, validated as a standard test in suspected thrombotic disorders. Elevated D-dimer levels were found also in a number of cancers. Its role in the prognosis of these cancers as well as in the mechanism of tumor development is still debated. OBJECTIVES: The aim of this study was to assess the reliability of D-dimer level in relation to clinical presentations, standard prognostic markers, and early outcomes in patients with classical HL. PATIENTS AND METHODS: This is a prospective cohort study enrolled 25 adult patients with newly diagnosed classical HL during a period of 1 year from different hematology centers in Iraq. In addition to clinical parameters, each patient had performed D-dimer assay by the expert specialist at the start of treatment and after the end of delete courses of chemotherapy cycles. RESULTS: An elevated mean D-dimer level was observed (1568.9 ± 1365.73 ng/mL). The stage of the disease showed a significant difference among the patients' groups (P = 0.042). In addition, the mean D-dimer was significantly different between chemotherapy responders and nonresponders (P = 0.004). Only D-dimer showed a significant association as a univariate predictor to prognosis (P = 0.003). CONCLUSION: There is significant a negative strong correlation in mean D-dimer values and the outcome (i.e., mean D-dimer significantly decrease with increased response).