-Martínez, jlfm@uniovi.es, 0034 985 103 199.
AbstractPurpose: The cure rate in Hodgkin Lymphoma is high, but the response along the treatment is still unpredictable and is highly variable among patients. Detecting those patients that do not respond to the treatment at early stages could bring improvements in their treatment. This research tries to identify the main biological prognostic variables currently gathered at diagnosis, and designing a simple machine learning methodology to help physicians improving the treatment response assessment. Methods: We carried out a retrospective analysis of the response to treatment for a cohort of 263 Caucasians who were diagnosed with Hodgkin Lymphoma in Asturias (Spain). For that purpose, we used a list of 35 clinical and biological variables that are currently measured at diagnosis, before any treatment begins. To establish the list of most discriminatory prognostic variables for the treatment response we designed a machine learning approach based on two different feature selection methods (Fisher's ratio and Maximum Percentile Distance) and recursive feature elimination using a nearest-neighbor classifier (k-NN). The weights of the k-NN classifier are optimized using different terms of the confusion matrix (true and false positive rates) in order to minimize risk in the decisions. Results and conclusions: We found that the optimum strategy to predict treatment response in Hodgkin lymphoma consists in solving two
Ferritin levels might correlate with disease activity in classical Hodgkin lymphoma (cHL). We analyzed the prognostic significance of the ferritin value at diagnosis in 173 cHL patients treated with ABVD between 2003 and 2013. The 5-year overall survival (OS) and progression-free survival (PFS) probabilities were 80% and 64%, respectively. Patients with ferritin ≥ 350 μg/l [high ferritin group (HF), n = 62] were more likely to have advanced stage disease, B-symptoms and higher International Prognostic Score (IPS) compared with patients with ferritin < 350 μg/l [low ferritin group (LF), n = 111]. The complete remission (CR) rate and 5-year PFS and OS probabilities were lower in HF vs. LF patients (69% vs. 89%, p = 0.025; 40% vs. 78%, p < 0.001; 61% vs. 90%, p = 0.001; respectively). Multivariate analysis revealed that advanced stage (p = 0.001) and ferritin levels ≥ 350 μg/l (p = 0.002) were independent predictors for PFS. In conclusion, the ferritin level at diagnosis is a useful prognostic marker for cHL.
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