Revised <scp>MALT‐IPI</scp>: A new predictive model that identifies high‐risk patients with extranodal marginal zone lymphoma

Alderuccio, Juan Pablo; Reis, Isildinha M.; Habermann, Thomas M.; Link, Brian K.; Thiéblemont, Catherine; Conconi, Annarita; Larson, Melissa C.; Cascione, Luciano; Zhao, Wei; Cerhan, James R.; Zucca, Emanuele; Fuente, Macarena I. de la

doi:10.1002/ajh.26715

Cited by 11 publications

(11 citation statements)

References 29 publications

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“…Studies on whether increased LDH is related to tumor survival have been reported for several solid tumors ( 9 - 13 ). The underlying mechanism between LDH and poor survival remains unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Lactate dehydrogenase (LDH) is a key enzyme involved in anaerobic glycolysis, mainly catalyzing the conversion between pyruvate and lactate, and the expression of serum LDH levels in tumor tissue is higher than that in normal tissue due to the fact that tumor cells are mainly powered by anaerobic fermentation ( 6 ) Patients may experience elevated serum LDH levels due to active cell proliferation, enhanced metabolism, and increased normal tissue infiltration prior to progression, leading to low survival rates in patients with tumor metastasis in various cancer types ( 7 ). A growing number of studies are providing insight into the relationship between LDH and overall survival (OS) in different malignancies, such melanoma ( 8 ), lymphoma ( 9 ), nasopharyngeal carcinoma ( 10 ), lung cancer ( 11 , 12 ), and pancreatic carcinoma ( 13 ). Several investigators also scrutinized the prognostic value of LDH in ESCC, such as ESCC patients receiving surgical treatment ( 14 - 16 ) or immunotherapy ( 17 , 18 ), or chemoradiotherapy but reached inconsistent conclusions ( 19 , 20 ), serum LDH thereby remains a controversial prognostic biomarker concerning its value in ESCC prognosis and needs to be further investigated.…”

Section: Introductionmentioning

confidence: 99%

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A new risk score model based on lactate dehydrogenase for predicting prognosis in esophageal squamous cell carcinoma treated with chemoradiotherapy

Liu¹,

Han²,

Han³

et al. 2023

J Thorac Dis

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Background The prognostic role of lactate dehydrogenase (LDH) has been confirmed in many malignant tumors, but it has not been widely discussed in esophageal squamous cell cancer (ESCC). This study aimed to assess the prognostic value of LDH in patients with ESCC and to generate a risk score model to predict prognosis in patients who were treated with chemoradiotherapy. Methods A total of 614 patients with ESCC who received chemoradiotherapy from 2012 to 2016 were examined in this single-center retrospective study. The optimal cutoff points for age, cytokeratin 19 fragment antigen 21-1 (Cyfra21-1), carcinoembryonic antigen (CEA), tumor length, total dose, and LDH were calculated by the X-tile software. We analyzed the association between the level of LDH and clinicopathological characteristics, and a 1:3 propensity score matching analysis was used to compensate for differences in baseline characteristics. Kaplan-Meier and Cox regression models were used to determine the prognostic factors for overall survival (OS) and progression-free survival (PFS). Based on the results, we developed a corresponding risk score model and established a nomogram to assess its predictive capacity. Results The optimal cutoff point of LDH was 134 U/L. Patients in the high-LDH group had significantly shorter PFS and worse OS than did those in the low-LDH group (all P values <0.05). Multivariate survival analysis indicated that pretreatment serum LDH level (P=0.039), Cyfra21-1 level (P=0.003), tumor length (P=0.013), clinical N stage (P=0.047), and clinical M stage (P=0.011) were independent predictors for OS in patients with ESCC who underwent chemoradiotherapy. Furthermore, a risk score model based on these 5 prognostic factors was established to divide patients into 3 prognostic groups to identify those patients with ESCC who were most likely to benefit from chemoradiotherapy (χ 2 =20.53; P<0.0001). However, the prediction nomogram that integrated the significant independent factors for OS is not performed very well in predicting survival (C-index =0.599). Conclusions Pretreatment serum LDH level may be a reliable factor in predicting the therapeutic effect of chemoradiotherapy in ESCC. Further validation is needed before this model can be widely used in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A new risk score model based on lactate dehydrogenase for predicting prognosis in esophageal squamous cell carcinoma treated with chemoradiotherapy

Liu¹,

Han²,

Han³

et al. 2023

J Thorac Dis

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“…Treatment ranges from active surveillance and/or antibiotics (particularly for Helicobacter pylori -positive gastric lymphomas) to surgery and/or multiagent chemotherapy. Given the patient’s young age, normal LDH and low stage disease, this patient was classified as low risk, 15,16 with acknowledgment that risk classification systems were validated in adult populations. With only sporadic descriptions of MALT lymphoma in children and young adults, management has been predictably heterogeneous without consensus in approach.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Extranodal Marginal Zone Lymphoma Mimicking Abdominal Cocoon Syndrome in an Adolescent Patient

Ohlsen,

Morse,

Ahmad

et al. 2023

Pediatr Dev Pathol

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Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is an indolent non-Hodgkin lymphoma rarely seen in pediatric patients. MALT lymphoma most commonly involves the gastrointestinal tract or peri-orbital tissues, potentially as sequela of chronic antigenic stimulation or immune dysregulation. Rare cases of MALT lymphoma arising from the gynecologic tract have been reported in older adult patients. We present the unique case of a 16-year-old postpubescent female with MALT lymphoma localized to the gynecologic tract, who initially presented with abdominal fullness, abnormal uterine bleeding, and obstructive acute kidney injury secondary to urinary outflow obstruction. Intraoperatively, dense fibrosis of the uterus and left fallopian tube was noted which mimicked abdominal cocoon syndrome. She was treated with 6 cycles of bendamustine and rituximab with complete anatomic and metabolic remission. In this report we highlight a very unusual presentation of a rare malignancy in the pediatric population as well as unique treatment considerations given this patient’s young age and tumor location.

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“…Also, we did not capture the biological correlates such as the presence of complex karyotype, MALT::BIRC3, or other common rearrangements specific to MZL, NOTCH , MYD88 , or TP53 mutation status, etc. which could influence prognosis in MZL or increase the risk of histologic transformation [ 14 – 17 ].…”

Section: To the Editormentioning

confidence: 99%

Impact of early relapse within 24 months after first-line systemic therapy (POD24) on outcomes in patients with marginal zone lymphoma: A US multisite study

Epperla,

Welkie,

Torka

et al. 2023

J Hematol Oncol

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Progression of disease within 24 months (POD24) from diagnosis in marginal zone lymphoma (MZL) was shown to portend poor outcomes in prior studies. However, many patients with MZL do not require immediate therapy, and the time from diagnosis-to-treatment interval can be highly variable with no universal criteria to initiate systemic therapy. Hence, we sought to evaluate the prognostic relevance of early relapse or progression within 24 months from systemic therapy initiation in a large US cohort. The primary objective was to evaluate the overall survival (OS) in the two groups. The secondary objective included the evaluation of factors predictive of POD24 and the assessment of cumulative incidence of histologic transformation (HT) in POD24 versus non-POD24 groups. The study included 524 patients with 143 (27%) in POD24 and 381 (73%) in non-POD24 groups. Patients with POD24 had inferior OS compared to those without POD24, regardless of the type of systemic therapy received (rituximab monotherapy or immunochemotherapy) at diagnosis. After adjusting for factors associated with inferior OS in the univariate Cox model, POD24 remained associated with significantly inferior OS (HR = 2.50, 95% CI = 1.53–4.09, p = 0.0003) in multivariable analysis. The presence of monoclonal protein at diagnosis and those who received first-line rituximab monotherapy had higher odds of POD24 on logistic regression analysis. Patients with POD24 had a significantly higher risk for HT compared to those without POD24. POD24 in MZL might be associated with adverse biology and could be used as an additional information point in clinical trials and investigated as a marker for worse prognosis.

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Revised MALT‐IPI: A new predictive model that identifies high‐risk patients with extranodal marginal zone lymphoma

Cited by 11 publications

References 29 publications

A new risk score model based on lactate dehydrogenase for predicting prognosis in esophageal squamous cell carcinoma treated with chemoradiotherapy

A new risk score model based on lactate dehydrogenase for predicting prognosis in esophageal squamous cell carcinoma treated with chemoradiotherapy

An Unusual Case of Extranodal Marginal Zone Lymphoma Mimicking Abdominal Cocoon Syndrome in an Adolescent Patient

Impact of early relapse within 24 months after first-line systemic therapy (POD24) on outcomes in patients with marginal zone lymphoma: A US multisite study

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