Simultaneous elevation in the serum concentrations of the angiogenic growth factors VEGF and bFGF is an independent predictor of poor prognosis in non-Hodgkin lymphoma: a single-institution study of 200 patients

High serum concentrations of vascular endothelial growth factor (S-VEGF) an d basic fibroblast growth factor (S-bFGF) are associated with unfavorable c linical characteristics in cancer. The combined effect of S-VEGF and S-bFGF on the survival of 200 patients with non-Hodgkin lymphoma (NHL) was studie d. High S-VEGF and S-bFGF at diagnosis were associated with poor survival w ith the medians, the highest tertiles, or the highest quartiles as the cuto ff values. The highest prognostic power was obtained when S-VEGF and S-bFGF were examined as a combination. Patients who had both S-VEGF and S-bFGF wi thin the highest quartiles had only a 21% 5-year survival rate in contrast to a 64% 5-year survival rate among patients with both factors within the 3 lowest quartiles (P < .0001), Simultaneous elevation of S-VEGF and S-bFGF was associated with poor survival in different grades of lymphomas and in t he largest histologic subgroup, the large-cell diffuse and immunoblastic ly mphomas. S-VEGF (relative risk [RR], 1.83; P = .019) and S-bFGF (RR, 2.02; P = .0049) had independent influences on survival in multivariate models wh en tested together with the components of the International Prognostic Inde x (IPI), Patients with both S-VEGF and S-bFGF within the highest quartiles had nearly 3 times higher risk for death (RR, 2.90; 95% confidence interval [CI], 1.56-5.40; P = .0008) than the rest of the patients. This RR was hig her than the relative risks associated with any of the components of the IP I in the same model. The authors conclude that the combination of S-VEGF an d S-bFGF is a powerful prognostic variable in NHL. (C) 2000 by The American Society of Hematology.