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A promising prognostic model for predicting survival of patients with HIV‐related diffuse large B‐cell lymphoma in the cART era

BACKGROUND: Optimization of risk stratification is important for facilitating prognoses and therapeutic decisions regarding diffuse large B‐cell lymphoma (DLBCL). However, a simple and applicable prognostic tool is lacking for individuals with human immunodeficiency virus (HIV)‐related DLBCL in the...

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Autores principales: Chen, Juanjuan, Wu, Yihua, Kang, Zixin, Qin, Shanfang, Ruan, Guangjing, Zhao, Han, Tao, Xin, Xie, Zhiman, Peng, Jie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278482/
https://www.ncbi.nlm.nih.gov/pubmed/37081761
http://dx.doi.org/10.1002/cam4.5957
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author Chen, Juanjuan
Wu, Yihua
Kang, Zixin
Qin, Shanfang
Ruan, Guangjing
Zhao, Han
Tao, Xin
Xie, Zhiman
Peng, Jie
author_facet Chen, Juanjuan
Wu, Yihua
Kang, Zixin
Qin, Shanfang
Ruan, Guangjing
Zhao, Han
Tao, Xin
Xie, Zhiman
Peng, Jie
author_sort Chen, Juanjuan
collection PubMed
description BACKGROUND: Optimization of risk stratification is important for facilitating prognoses and therapeutic decisions regarding diffuse large B‐cell lymphoma (DLBCL). However, a simple and applicable prognostic tool is lacking for individuals with human immunodeficiency virus (HIV)‐related DLBCL in the era of combined antiretroviral therapy (cART). METHODS: This retrospective multicenter observational study included 147 HIV‐related DLBCL patients with histologically confirmed DLBCL from 2013 to 2020. The total group was divided into training (n = 78) and validation (n = 69) cohorts to derive the best prognostic score. Clinicopathological and characteristic biomarkers correlated with clinical outcomes were analyzed. RESULTS: Age, Ann Arbor stage, lactate dehydrogenase (LDH) ratio, bulky disease, and red blood cell distribution width (RDW) ratio retained robust independent correlations with overall survival (OS) in multivariate analysis. A new and practical prognostic model was generated and externally validated, classifying patients into three categories with significantly different survival rates. Moreover, the new index outperformed the International Prognostic Index (IPI) score (area under the curve values of 0.94 vs. 0.81 in the training cohort and 0.85 vs. 0.74 in the validation cohort, C‐indices of 0.80 vs. 0.70 in the training cohort and 0.74 vs. 0.70 in the validation cohort, and integrated discrimination improvement values of 0.203 in the training cohort and 0.175 in the validation cohort) and was better at defining intermediate‐ and high‐risk groups. The calibration curves performed satisfactorily for predicting 3‐year OS in the training and validation cohorts. CONCLUSIONS: We developed and validated a simple and feasible prognostic model for patients with HIV‐related DLBCL that had more discriminative and predictive accuracy than the IPI score for risk stratification and individualized treatment in the cART era.
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spelling pubmed-102784822023-06-20 A promising prognostic model for predicting survival of patients with HIV‐related diffuse large B‐cell lymphoma in the cART era Chen, Juanjuan Wu, Yihua Kang, Zixin Qin, Shanfang Ruan, Guangjing Zhao, Han Tao, Xin Xie, Zhiman Peng, Jie Cancer Med RESEARCH ARTICLES BACKGROUND: Optimization of risk stratification is important for facilitating prognoses and therapeutic decisions regarding diffuse large B‐cell lymphoma (DLBCL). However, a simple and applicable prognostic tool is lacking for individuals with human immunodeficiency virus (HIV)‐related DLBCL in the era of combined antiretroviral therapy (cART). METHODS: This retrospective multicenter observational study included 147 HIV‐related DLBCL patients with histologically confirmed DLBCL from 2013 to 2020. The total group was divided into training (n = 78) and validation (n = 69) cohorts to derive the best prognostic score. Clinicopathological and characteristic biomarkers correlated with clinical outcomes were analyzed. RESULTS: Age, Ann Arbor stage, lactate dehydrogenase (LDH) ratio, bulky disease, and red blood cell distribution width (RDW) ratio retained robust independent correlations with overall survival (OS) in multivariate analysis. A new and practical prognostic model was generated and externally validated, classifying patients into three categories with significantly different survival rates. Moreover, the new index outperformed the International Prognostic Index (IPI) score (area under the curve values of 0.94 vs. 0.81 in the training cohort and 0.85 vs. 0.74 in the validation cohort, C‐indices of 0.80 vs. 0.70 in the training cohort and 0.74 vs. 0.70 in the validation cohort, and integrated discrimination improvement values of 0.203 in the training cohort and 0.175 in the validation cohort) and was better at defining intermediate‐ and high‐risk groups. The calibration curves performed satisfactorily for predicting 3‐year OS in the training and validation cohorts. CONCLUSIONS: We developed and validated a simple and feasible prognostic model for patients with HIV‐related DLBCL that had more discriminative and predictive accuracy than the IPI score for risk stratification and individualized treatment in the cART era. John Wiley and Sons Inc. 2023-04-20 /pmc/articles/PMC10278482/ /pubmed/37081761 http://dx.doi.org/10.1002/cam4.5957 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Chen, Juanjuan
Wu, Yihua
Kang, Zixin
Qin, Shanfang
Ruan, Guangjing
Zhao, Han
Tao, Xin
Xie, Zhiman
Peng, Jie
A promising prognostic model for predicting survival of patients with HIV‐related diffuse large B‐cell lymphoma in the cART era
title A promising prognostic model for predicting survival of patients with HIV‐related diffuse large B‐cell lymphoma in the cART era
title_full A promising prognostic model for predicting survival of patients with HIV‐related diffuse large B‐cell lymphoma in the cART era
title_fullStr A promising prognostic model for predicting survival of patients with HIV‐related diffuse large B‐cell lymphoma in the cART era
title_full_unstemmed A promising prognostic model for predicting survival of patients with HIV‐related diffuse large B‐cell lymphoma in the cART era
title_short A promising prognostic model for predicting survival of patients with HIV‐related diffuse large B‐cell lymphoma in the cART era
title_sort promising prognostic model for predicting survival of patients with hiv‐related diffuse large b‐cell lymphoma in the cart era
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278482/
https://www.ncbi.nlm.nih.gov/pubmed/37081761
http://dx.doi.org/10.1002/cam4.5957
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