Urinary Albumin Excretion is a Predictor of Response to Treatment and Disease Progression in Low-Grade non-Hodgkin's Lymphoma

Slightly increased urinary albumin excretion (UAE) is frequently found in patients with malignant diseases and is associated with adverse prognostic factors. In the present study, the main objective was to elucidate the role of UAE as predictor of response to treatment and time to progression in low-grade non-Hodgkin's lymphoma. We included 52 patients with newly diagnosed follicular lymphoma grade 1 and 2. Pre- and post-treatment median UAE level was 17.5 and 12.0 μg/min, respectively (P < 0.01). Significantly more patients with a pre-treatment UAE below the median level were in CR after treatment (P < 0.05). Patients with a clinical response to treatment had a significantly lower frequency of UAE above the median post-treatment level (P < 0.05). UAE at the time of progression increased to a significantly higher level compared with the post-treatment level (26.5 vs. 16.0 μg/min; P < 0.0001). Median response duration and progression-free survival were significantly longer in patients with a post-treatment UAE below the median level (P < 0.001 and P < 0.0001, respectively). In conclusion, we found elevated UAE to be a highly sensitive indicator of clinical behavior in newly diagnosed low-grade lymphoma. Both response to treatment and time to progression were predicted by levels of UAE. Further studies are needed to confirm the clinical implications of UAE in lymphoma patients.