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A prognostic index predicting survival in transformed Waldenström macroglobulinemia
Histological transformation into diffuse large B-cell lymphoma is a rare complication in patients with Waldenström macroglobulinemia (WM) and is usually associated with a poor prognosis. The objective of this study was to develop and validate a prognostic index for survival of patients with transfor...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Fondazione Ferrata Storti
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8561274/ https://www.ncbi.nlm.nih.gov/pubmed/33179472 http://dx.doi.org/10.3324/haematol.2020.262899 |
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author | Durot, Eric Kanagaratnam, Lukshe Zanwar, Saurabh Kastritis, Efstathios D’Sa, Shirley Garcia-Sanz, Ramon Tomowiak, Cécile Hivert, Bénédicte Toussaint, Elise Protin, Caroline Abeykoon, Jithma P. Guerrero-Garcia, Thomas Itchaki, Gilad Vos, Josephine M. Michallet, Anne-Sophie Godet, Sophie Dupuis, Jehan Leprêtre, Stéphane Bomsztyk, Joshua Morel, Pierre Leblond, Véronique Treon, Steven P. Dimopoulos, Meletios A. Kapoor, Prashant Delmer, Alain Castillo, Jorge J. |
author_facet | Durot, Eric Kanagaratnam, Lukshe Zanwar, Saurabh Kastritis, Efstathios D’Sa, Shirley Garcia-Sanz, Ramon Tomowiak, Cécile Hivert, Bénédicte Toussaint, Elise Protin, Caroline Abeykoon, Jithma P. Guerrero-Garcia, Thomas Itchaki, Gilad Vos, Josephine M. Michallet, Anne-Sophie Godet, Sophie Dupuis, Jehan Leprêtre, Stéphane Bomsztyk, Joshua Morel, Pierre Leblond, Véronique Treon, Steven P. Dimopoulos, Meletios A. Kapoor, Prashant Delmer, Alain Castillo, Jorge J. |
author_sort | Durot, Eric |
collection | PubMed |
description | Histological transformation into diffuse large B-cell lymphoma is a rare complication in patients with Waldenström macroglobulinemia (WM) and is usually associated with a poor prognosis. The objective of this study was to develop and validate a prognostic index for survival of patients with transformed WM. Through this multicenter, international collaborative effort, we developed a scoring system based on data from 133 patients with transformed WM who were evaluated between 1995 and 2016 (training cohort). Univariate and multivariate analyses were used to propose a prognostic index with 2-year survival after transformation as an endpoint. For external validation, a dataset of 67 patients was used to evaluate the performance of the model (validation cohort). By multivariate analysis, three adverse covariates were identified as independent predictors of 2-year survival after transformation: elevated serum lactate dehydrogenase (2 points), platelet count <100x109/L (1 point) and any previous treatment for WM (1 point). Three risk groups were defined: low-risk (0-1 point, 24% of patients), intermediate-risk (2-3 points, 59%; hazard ratio = 3.4) and high-risk (4 points, 17%; hazard ratio = 7.5). Two-year survival rates were 81%, 47%, and 21%, respectively (P<0.0001). This model appeared to be a better discriminant than either the International Prognostic Index or the revised International Prognostic Index. We validated this model in an independent cohort. This easy-to-compute scoring index is a robust tool that may allow identification of groups of transformed WM patients with different outcomes and could be used for improving the development of risk-adapted treatment strategies. |
format | Online Article Text |
id | pubmed-8561274 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Fondazione Ferrata Storti |
record_format | MEDLINE/PubMed |
spelling | pubmed-85612742021-11-10 A prognostic index predicting survival in transformed Waldenström macroglobulinemia Durot, Eric Kanagaratnam, Lukshe Zanwar, Saurabh Kastritis, Efstathios D’Sa, Shirley Garcia-Sanz, Ramon Tomowiak, Cécile Hivert, Bénédicte Toussaint, Elise Protin, Caroline Abeykoon, Jithma P. Guerrero-Garcia, Thomas Itchaki, Gilad Vos, Josephine M. Michallet, Anne-Sophie Godet, Sophie Dupuis, Jehan Leprêtre, Stéphane Bomsztyk, Joshua Morel, Pierre Leblond, Véronique Treon, Steven P. Dimopoulos, Meletios A. Kapoor, Prashant Delmer, Alain Castillo, Jorge J. Haematologica Article Histological transformation into diffuse large B-cell lymphoma is a rare complication in patients with Waldenström macroglobulinemia (WM) and is usually associated with a poor prognosis. The objective of this study was to develop and validate a prognostic index for survival of patients with transformed WM. Through this multicenter, international collaborative effort, we developed a scoring system based on data from 133 patients with transformed WM who were evaluated between 1995 and 2016 (training cohort). Univariate and multivariate analyses were used to propose a prognostic index with 2-year survival after transformation as an endpoint. For external validation, a dataset of 67 patients was used to evaluate the performance of the model (validation cohort). By multivariate analysis, three adverse covariates were identified as independent predictors of 2-year survival after transformation: elevated serum lactate dehydrogenase (2 points), platelet count <100x109/L (1 point) and any previous treatment for WM (1 point). Three risk groups were defined: low-risk (0-1 point, 24% of patients), intermediate-risk (2-3 points, 59%; hazard ratio = 3.4) and high-risk (4 points, 17%; hazard ratio = 7.5). Two-year survival rates were 81%, 47%, and 21%, respectively (P<0.0001). This model appeared to be a better discriminant than either the International Prognostic Index or the revised International Prognostic Index. We validated this model in an independent cohort. This easy-to-compute scoring index is a robust tool that may allow identification of groups of transformed WM patients with different outcomes and could be used for improving the development of risk-adapted treatment strategies. Fondazione Ferrata Storti 2020-11-12 /pmc/articles/PMC8561274/ /pubmed/33179472 http://dx.doi.org/10.3324/haematol.2020.262899 Text en Copyright© 2021 Ferrata Storti Foundation https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (by-nc 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Article Durot, Eric Kanagaratnam, Lukshe Zanwar, Saurabh Kastritis, Efstathios D’Sa, Shirley Garcia-Sanz, Ramon Tomowiak, Cécile Hivert, Bénédicte Toussaint, Elise Protin, Caroline Abeykoon, Jithma P. Guerrero-Garcia, Thomas Itchaki, Gilad Vos, Josephine M. Michallet, Anne-Sophie Godet, Sophie Dupuis, Jehan Leprêtre, Stéphane Bomsztyk, Joshua Morel, Pierre Leblond, Véronique Treon, Steven P. Dimopoulos, Meletios A. Kapoor, Prashant Delmer, Alain Castillo, Jorge J. A prognostic index predicting survival in transformed Waldenström macroglobulinemia |
title | A prognostic index predicting survival in transformed Waldenström macroglobulinemia |
title_full | A prognostic index predicting survival in transformed Waldenström macroglobulinemia |
title_fullStr | A prognostic index predicting survival in transformed Waldenström macroglobulinemia |
title_full_unstemmed | A prognostic index predicting survival in transformed Waldenström macroglobulinemia |
title_short | A prognostic index predicting survival in transformed Waldenström macroglobulinemia |
title_sort | prognostic index predicting survival in transformed waldenström macroglobulinemia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8561274/ https://www.ncbi.nlm.nih.gov/pubmed/33179472 http://dx.doi.org/10.3324/haematol.2020.262899 |
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