Factors affecting survival in elderly patients with diffuse large B-Cell lymphoma

Ulu, Bahar Uncu; Yiğenoğlu, Tuğçe Nur; Başçı, Semih; Bakırtaş, Mehmet; Şahin, Derya; Darçın, Tahir; Yaman, Samet; Bozan, Ersin; Secilmis, Sema; Candır, Burcu Arslan; Yıldız, Jale; İskender, Dicle; Baysal, Nuran Ahu; Çakar, Merih Kızıl; Altuntaş, Fevzi

doi:10.1016/j.leukres.2021.106700

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Multiple studies have also confirmed that patients who achieve complete remission have a better prognosis. 34 , 35 For patients with large tumors at initial diagnosis, especially in the early stages, surgical resection of the tumor to reduce tumor burden and adjuvant chemotherapy can improve patient survival. 36 For patients who are resistant to chemotherapy, surgery may be the main treatment method.…”

Section: Discussionmentioning

confidence: 99%

A Novel and Validated Inflammation-Based Prognosis Score (IBPS) Predicts Outcomes in Patients with Diffuse Large B-Cell Lymphoma

Liu¹,

Li²,

Hua³

et al. 2023

CMAR

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Purpose We aimed to create a novel prognostic score, the inflammation-based prognosis score (IBPS). In addition, we attempted to establish and validate a nomogram to predict the overall survival (OS) of patients with DLBCL. Patients and Methods We retrospectively investigated the data of 213 patients with DLBCL diagnosed and treated in the Affiliated Hospital of Jiangnan University and used these data to develop nomograms. At the same time, 89 patients diagnosed and treated in Wuxi People’s Hospital Affiliated with Nanjing Medical University from January 2015 to June 2021 were collected as an external validation cohort. We developed IBPS through the least absolute shrinkage and selection operator (LASSO) Cox regression. The univariate and multivariate Cox regression method was used to develop the nomogram. We used the concordance index (C-index), calibration chart, time-dependent receiver operating characteristic (ROC) analysis, decision curve analysis (DCA), and the Kaplan–Meier curve were used to assess the nomogram. Results The systemic immune inflammation index (SII), prognostic nutrition index (PNI), and modified Glasgow prognostic score (mGPS) were used to construct IBPS. The Eastern Cooperative Oncology Group performance status (ECOG PS), IBPS, response to treatment, and whether accept surgery were used to construct the nomogram to predict the OS of DLBCL patients. The C-index in the training and validation cohorts were 0.844 and 0.828, respectively. According to the time-dependent ROC curve and DCA, the nomogram has good predictive accuracy and clinical net benefit. The Kaplan–Meier curve showed that according to the nomogram score, patients in the training and validation cohorts could be classified into three risk groups. Conclusion In patients with DLBCL, baseline IBPS was a reliable predictor of OS. The survival probability of DLBCL patients can be precisely predicted using the prognosis nomogram based on IBPS.

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Section: Discussionmentioning

confidence: 99%

A Novel and Validated Inflammation-Based Prognosis Score (IBPS) Predicts Outcomes in Patients with Diffuse Large B-Cell Lymphoma

Liu¹,

Li²,

Hua³

et al. 2023

CMAR

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“…Notably, compared to the R-IPI, the ESPI demonstrated the ability to identify intermediate-risk groups and showed a trend toward increased predictive accuracy. Although several studies showed age was a prognostic factor in elderly DLBCL, 38,39 patients were treated by various regimens in the previous cohorts. In our study, in which R-CHOP was performed in most patients, the prognostic impact of age was diminished when sarcopenia was considered a risk factor.…”

Section: Development Of a New Prognostic Model Incorporating Sarcopen...mentioning

confidence: 99%

Skeletal muscle index impacts the treatment outcome of elderly patients with diffuse large B cell lymphoma

Niiyama‐Uchibori,

Okamoto,

Miyashita

et al. 2024

Hematological Oncology

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Sarcopenia is a crucial factor in the physical fitness of elderly individuals. This study investigated the prognostic values of multiple parameters of sarcopenia in association with established prognostic factors in elderly Japanese patients with diffuse large B cell lymphoma (DLBCL). As candidate indicators for sarcopenia, the skeletal muscle index (SMI) (cm2/m2), the psoas muscle index, the erector spinae muscle index, the visceral fat index, the subcutaneous fat index, and the visceral to subcutaneous fat area ratio at the third lumbar level were assessed by computed tomography at their initial diagnosis in 102 patients with DLBCL over 75 years old those were diagnosed and treated in our institute from 2007 to 2020. The primary endpoint was overall survival (OS), and the secondary endpoint was progression‐free survival (PFS). The median age of patients analyzed was 80 years at diagnosis. The sex‐specific cut‐offs for the indices adopted two approaches: (i) the historical cut‐off values established in the previous study for healthy Japanese individuals (Hamaguchi Y. J Cachexia Sarcopenia Muscle. 2018), and (ii) each sex‐specific lowest quartile in our cohort. As the results, SMI evaluated by the historical cut‐off and sex‐specific lowest quartile was identified as the most influential independent prognostic factor for both OS and PFS among various parameters for sarcopenia. Furthermore, we developed an elderly sarcopenia prognostic index (ESPI). ESPI, which combines SMI evaluated by the historical cut‐off and LDH > ULN, demonstrated statistically significant prognostic impacts on OS and PFS. Moreover, compared to the R‐IPI, ESPI showed the ability to identify intermediate‐risk groups and indicated a trend toward improved predictive accuracy. Our study revealed that SMI is the most appropriate assessment method for evaluating sarcopenia and the critical prognostic factor in OS and PFS of elderly patients with DLBCL.

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“…The size of the tumor, Ann Arbor stage, and extranodal and BM involvement are all factors to consider. 7 , 8 The International NHL Prognostic Factors Project created the international prognostic index (IPI), assigning one point to each of the following negative prognostic factors: older than 60 years, Ann Arbor stage III to IV, two or more extranodal site involvement, PS 2 or higher, and serum LDH level above the normal high level. The newly designed therapies resulted in the emergence of the less complex revised IPI (R-IPI) with a more remarkable ability to detect patients’ long-term outcomes.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological Characteristics and Prognosis of Diffuse Large B-Cell Lymphoma in Relation to CA-125 and CA 19-9 Expression

Foda,

Atia,

Sakr

et al. 2023

J Evid Based Complementary Altern Med

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Background: Some epithelial tumors express the carbohydrate antigen 125 (Cancer antigen-125, CA-125) and CA 19-9, especially ovarian and pancreatic tumors. Patients with non-Hodgkin lymphoma (NHL) were reported to have a close association between serum CA-125 levels and adverse prognostic factors with worse survival. We aimed to investigate CA-125 and 19-9 expression in nodal diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) tissues using immunohistochemistry (IHC) and their relations to clinicopathological manifestations and patients' survival. Methods: 65 cases of DLBCL NOS were examined. A modified mechanical pencil tip was used to construct Manual Tissue Micro-array (TMA) blocks. Immunohistochemical staining for CA-125 and CA 19-9 was performed and scored semi-quantitatively. All relations were analyzed using established statistical methodologies. Results: Aberrant expression of CA 19-9 was detected in 12% of cases without any expression of CA-125. Moreover, 75% of the CA 19-9 positive cases were statistically significantly associated with anemia and performance status 1. Also, 75% of the CA 19-9 positive cases were females. Conclusions: CA 19-9 was aberrantly expressed in 12% of nodal DLBCL NOS cases and significantly related to anaemia and performance status but not to survival. In cases of DLBCL NOS, CA 19-9 expression cannot be considered an independent prognostic factor. CA-125 was not expressed in nodal DLBCL NOS tissues, necessitating re-evaluation studies. Therefore, it is advised to conduct more research to clarify the potential correlation between serum and tissue CA 19-9 levels and other clinic-pathological characteristics of nodal and extranodal DLBCL NOS patients.

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Factors affecting survival in elderly patients with diffuse large B-Cell lymphoma

Cited by 3 publications

References 29 publications

A Novel and Validated Inflammation-Based Prognosis Score (IBPS) Predicts Outcomes in Patients with Diffuse Large B-Cell Lymphoma

A Novel and Validated Inflammation-Based Prognosis Score (IBPS) Predicts Outcomes in Patients with Diffuse Large B-Cell Lymphoma

Skeletal muscle index impacts the treatment outcome of elderly patients with diffuse large B cell lymphoma

Clinicopathological Characteristics and Prognosis of Diffuse Large B-Cell Lymphoma in Relation to CA-125 and CA 19-9 Expression

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