Beta2-microglobulin is a valuable marker and identifies a poor-prognosis subgroup among intermediate-risk patients with diffuse large B cell lymphoma

Chen, Ning-Chun; Chang, Hong-Yeh; Kao, Hsiao‐Wen; Ou, Che-Wei; Kuo, Ming‐Chung; Wang, Po‐Nan; Lin, Tsan-Shiun; Wu, Jin‐Hou; Hung, Yu‐Shin; Su, Yi‐Jiun; Ong, Yuen-Chin; Shih, Hsuan‐Jen

doi:10.1007/s10238-023-01061-w

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(1 citation statement)

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“…For Ki-67, it has been shown that high Ki67 index is an important adverse prognostic factor in DLBCL patients after the introduction of rituximab [ 25 , 26 ]. For LDH, the standard prognostic score IPI has included LDH in the prognosis stratification of DLBCL patients, and high LDH indicates poor prognosis [ 18 , 27 ].For β2 microglobulin, some studies have shown that β2 microglobulin can identify subsets with poor prognosis in intermediate-risk patients with DLBCL [ 28 ] and may improve NCCN-IPI score [ 29 ]. For ferritin, some studies have shown that the prognostic model incorporating ferritin has better prognostic stratification ability than IPI for DLBCL [ 30 ].…”

Section: Discussmentioning

confidence: 99%

Development and validation of a novel prognostic nomogram for advanced diffuse large B cell lymphoma

Wan,

Zhang,

Huang

et al. 2024

Clin Exp Med

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Advanced diffuse large B cell lymphoma (DLBCL) is a common malignant tumor with aggressive clinical features and poor prognosis. At present, there is lack of effective prognostic tool for patients with advanced (stage III/IV) DLBCL. The aim of this study is to identify prognostic indicators that affect survival and response and establish the first survival prediction nomogram for advanced DLBCL. A total of 402 patients with advanced DLBCL were enrolled in this study. COX multivariate analysis was used to obtain independent prognostic factors. The independent prognostic factors were included in the nomogram, and the nomogram to predict the performance of the model was established by R rms package, C-index (consistency index), AUC curve and calibration curve. The training and validation cohorts included 281 and 121 patients. In the training cohort, multivariate analysis showed that Ki-67 (70% (high expression) vs ≤ 70% (low expression), p < 0.001), LDH (lactate dehydrogenase) (elevated vs normal, p = 0.05), FER (ferritin) (elevated vs normal, p < 0.001), and β2-microglobulin (elevated vs normal, p < 0.001) were independent predictors and the nomogram was constructed. The nomogram showed that there was a significant difference in OS among the low-risk, intermediate-risk and high-risk groups, with 5-year survival rates of 81.6%, 44% and 6%, respectively. The C-index of the nomogram in the training group was 0.76. The internal validation of the training group showed good consistency. In the internal validation cohort of the training group, the AUC was 0.828, and similar results were obtained in the validation group, with a C-index of 0.74 and an AUC of 0.803. The proposed nomogram provided a valuable individualized risk assessment of OS in advanced DLBCL patients.

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