Prognostic Nomogram and Predictive Factors in Refractory or Relapsed Diffuse Large B-Cell Lymphoma Patients Failing Front-Line R-CHOP Regimens

Jiang, Shiyu; Qin, Yan; Liu, Peng; Yang, Jianliang; Yang, Sheng; He, Xiaohong; Zhou, Shengyu; Gui, Lin; Zhang, Changgong; Zhou, Liqiang; Sun, Yan; Shi, Yuankai

doi:10.7150/jca.36997

Cited by 8 publications

(6 citation statements)

References 44 publications

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“…The recurrence rate of MALT lymphoma during the early stage is lower than during the late stage, which has been confirmed in our study. Different treatments have different prognoses, so some studies have incorporated the treatment model of patients into the prognostic model (29)(30)(31)(32)(33). Our study also found that radiotherapy was an independent factor affecting the PFS in MALT lymphoma.…”

Section: Discussionsupporting

confidence: 63%

A new prognostic nomogram in patients with mucosa-associated lymphoid tissue lymphoma: a multicenter retrospective study

Wen

Zhao

et al. 2023

Front. Oncol.

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BackgroundThe present study sought to understand how clinical factors and inflammatory biomarkers affected the prognosis of mucosa-associated lymphoid tissue (MALT) lymphoma and develop a predictive nomogram to assist in clinical practice.MethodsWe conducted a retrospective study on 183 cases of newly diagnosed MALT lymphoma from January 2011 to October 2021, randomly divided into two groups: a training cohort (75%); and a validation cohort (25%). The least absolute shrinkage and selection operator (LASSO) regression analysis was combined with multivariate Cox regression analysis to construct a nomogram for predicting the progression-free survival (PFS) in patients with MALT lymphoma. To evaluate the accuracy of the nomogram model, the area under the receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used.ResultsThe PFS was significantly associated with the Ann Arbor Stage, targeted therapy, radiotherapy, and platelet-to-lymphocyte ratio (PLR) in MALT lymphoma. These four variables were combined to establish a nomogram to predict the PFS rates at three and five years. Importantly, our nomogram yielded good predictive value with area under the ROC curve (AUC) values of 0.841 and 0.763 in the training cohort and 0.860 and 0.879 in the validation cohort for the 3-year and 5-year PFS, respectively. Furthermore, the 3-year and 5-year PFS calibration curves revealed a high degree of consistency between the prediction and the actual probability of relapse. Additionally, DCA demonstrated the net clinical benefit of this nomogram and its ability to identify high-risk patients accurately.ConclusionThe new nomogram model could accurately predict the prognosis of MALT lymphoma patients and assist clinicians in designing individualized treatments.

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Section: Discussionsupporting

confidence: 63%

A new prognostic nomogram in patients with mucosa-associated lymphoid tissue lymphoma: a multicenter retrospective study

Wen

Zhao

et al. 2023

Front. Oncol.

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“…The research of Duan et al also indicated that levels of Hs-CRP were independently correlated with END in patients with atrial fibrillation as well as stroke [18], and our previous study showed that Hs-CRP can predict the deterioration of motor function in patients with penetrating artery infarctions [17], too. The predictors that make up the nomogram are independent factors which are selected according to the results of multivariate regression [21][22][23][24][25][26]46]. Although some other variables, such as cardioembolism subtype and small artery occlusion subtype, might seem different between the END group and the non-END group, they have not been utilized to compose the nomogram for END because these variables had been adjusted by multivariate logistic regression.…”

Section: Discussionmentioning

confidence: 99%

“…The risk factors are selected based on the results of multivariate logistic regression. Nowadays, nomograms are widely applied to cancer prognosis [22,23], complications after surgery [24,25] and outcomes after intravenous thrombolysis for stroke [26,27], but there are few studies that concentrate on the establishment of a nomogram to predict END in patients with AIS. Therefore, the current study was performed to investigate the risk factors associated with END after AIS and a novel nomogram was constructed to predict END with external validation.…”

Section: Introductionmentioning

confidence: 99%

A novel nomogram to predict early neurological deterioration in patients with acute ischaemic stroke

Gong

Zhang

Gong

et al. 2020

Euro J of Neurology

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Background and purpose Acute ischaemic stroke (AIS) is a vital cause of mortality and morbidity in China. Many AIS patients develop early neurological deterioration (END). This study aimed to construct a nomogram to predict END in AIS patients. Methods Acute ischaemic stroke patients in Nanjing First Hospital were recruited as the training cohort. Additional patients in Nantong Third People’s Hospital were enrolled as the validation cohort. Multivariate logistic regression was utilized to establish the nomogram. Discrimination and calibration performance of the nomogram were tested by concordance index and calibration plots. Decision curve analysis was employed to assess the utility of the nomogram. Results In all, 1889 and 818 patients were recruited in the training and validation cohorts, respectively. Age [odds ratio (OR) 1.075; 95% confidence interval (CI) 1.059–1.091], diabetes mellitus (OR 1.673; 95% CI 1.181–2.370), atrial fibrillation (OR 3.297; 95% CI 2.005–5.421), previous antiplatelet medication (OR 0.473; 95% CI 0.301–0.744), hyper‐sensitive C‐reactive protein (OR 1.049; 95% CI 1.036–1.063) and baseline National Institutes of Health Stroke Scale (OR 1.071; 95% CI 1.045–1.098) were associated with END and incorporated in the nomogram. The concordance index was 0.826 (95% CI 0.785–0.885) and 0.798 (95% CI 0.749–0.847) in the training and validation cohorts. By decision curve analysis, the model was relevant between thresholds of 0.06 and 0.90 in the training cohort and 0.08 and 0.77 in the validation cohort. Conclusions The nomogram composed of hyper‐sensitive C‐reactive protein, age, diabetes mellitus, atrial fibrillation, previous antiplatelet medication and baseline National Institutes of Health Stroke Scale may predict the risk of END in AIS patients.

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“…Our study was conducted to identify whether second salvage chemotherapy provided any long-term progression-free or overall survival. A number of factors have been previously identified to significantly affect responses and outcomes to further treatment, including time to relapse from initial treatment, use of and response to upfront rituximab, and secondary age-adjusted IPI [ 24 ]. Refractoriness to, or early relapse after, CHOP chemotherapy is considered an indicator of poor response to second-line chemotherapy regimens [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Diffuse Large B-Cell Non-Hodgkin’s Lymphoma After Gemcitabine-Based Second Salvage Chemotherapy: A Single-Center Study

Jhatial¹,

Khan²,

Rab³

et al. 2021

Cureus

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Background Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin’s lymphoma with a five-year survival of 60%-70% with chemoimmunotherapy consisting of the R-CHOP combination (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone), with a relapse/refractory rate of 20-50%. Salvage therapy with HDT-ASCT is the treatment of choice for patients with relapsed/refractory disease with a success rate of 50%-60%. Patients who do not respond to the first salvage regimen or who relapsed after the first salvage regimen, with or without high-dose chemotherapy (HDT)-autologous stem cell transplantation (ASCT), have poor overall responses and survival and should be offered novel therapies. The objective of our study was to evaluate responses to second salvage, gemcitabine-based therapy with or without HDT-ASCT in a resource-limited setting. Materials and methods This was a retrospective study, including 55 patients aged >18 years, diagnosed with DLBCL and having received gemcitabine-based second salvage chemotherapy. Results The median age was 34 years, only one patient achieved progression-free survival (PFS) of >12 months with ORR of 27% to two cycles of gemcitabine-based combination, two years PFS and OS of 9.6% and 34%, respectively, and a median PFS and OS of four months and 13 months, respectively. Conclusion DLBCL patients, refractory to first-line and first salvage chemotherapy, should be considered for novel therapies or opt for palliative care rather than second salvage chemotherapy and HDT-ASCT, which results in poor overall response and significant toxicities.

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Prognostic Nomogram and Predictive Factors in Refractory or Relapsed Diffuse Large B-Cell Lymphoma Patients Failing Front-Line R-CHOP Regimens

Cited by 8 publications

References 44 publications

A new prognostic nomogram in patients with mucosa-associated lymphoid tissue lymphoma: a multicenter retrospective study

A new prognostic nomogram in patients with mucosa-associated lymphoid tissue lymphoma: a multicenter retrospective study

A novel nomogram to predict early neurological deterioration in patients with acute ischaemic stroke

Outcomes of Diffuse Large B-Cell Non-Hodgkin’s Lymphoma After Gemcitabine-Based Second Salvage Chemotherapy: A Single-Center Study

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