Hypomagnesemia at the time of autologous stem cell transplantation for patients with diffuse large B-cell lymphoma is associated with an increased risk of failure

• Main Authors: Jennifer J. Gile, Camden L. Lopez, Gordon J. Ruan, Matthew A. Hathcock, Jithma P. Abeykoon, Joy R. Heimgartner, Nikola A. Baumann, M. Molly McMahon, Ivana N. Micallef, Patrick B. Johnston, Jose C. Villasboas Bisneto, Luis F. Porrata, Jonas Paludo, Stephen M. Ansell, William J. Hogan, Thomas E. Witzig
• Format: Article
• Language: English
• Published: Nature Publishing Group 2021-03-01
• Series: Blood Cancer Journal
• Online Access: https://doi.org/10.1038/s41408-021-00452-0

Abstract Magnesium is an essential element that is involved in critical metabolic pathways. A diet deficient in magnesium is associated with an increased risk of developing cancer. Few studies have reported whether a serum magnesium level below the reference range (RR) is associated with prognosis in patients with diffuse large B cell lymphoma (DLBCL). Using a retrospective approach in DLBCL patients undergoing autologous stem cell transplant (AHSCT), we evaluated the association of hypomagnesemia with survival. Totally, 581 patients eligible for AHSCT with a serum magnesium level during the immediate pre-transplant period were identified and 14.1% (82/581) had hypomagnesemia. Hypomagnesemia was associated with an inferior event-free (EFS) and overall survival (OS) compared to patients with a serum magnesium level within RR; median EFS: 3.9 years (95% CI: 1.63–8.98 years) versus 6.29 years (95% CI: 4.73–8.95 years) with HR 1.63 (95% CI: 1.09–2.43, p = 0.017) for EFS, and median OS: 7.3 years (95% CI: 2.91—upper limit not estimable) versus 9.7 years (95% CI: 6.92–12.3 years) with HR 1.90 (95% CI: 1.22–2.96, p = 0.005) for OS months 0–12, respectively. These findings suggest a potentially actionable prognostic factor for patients with DLBCL undergoing AHSCT.