Risk factors analysis and nomogram development for myelosuppression in diffuse large B-cell lymphoma patients undergoing first-line chemotherapy: a dual-centre retrospective cohort study

Objective The primary objective of this research was to examine the characteristics of myelosuppression following first-line chemotherapy in patients suffering from diffuse large B-cell lymphoma (DLBCL). Furthermore, the study aimed to identify and analyze the risk factors impacting myelosuppression...

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Main Authors: Xuexing Wang, Rong Zhang, Haoling Xie, Jinsong Xu, Jie Chu, Chunmei Wei, Quanfang Chen
Format: Article
Language:English
Published: PeerJ Inc. 2025-06-01
Series:PeerJ
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Online Access:https://peerj.com/articles/19539.pdf
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author Xuexing Wang
Rong Zhang
Haoling Xie
Jinsong Xu
Jie Chu
Chunmei Wei
Quanfang Chen
author_facet Xuexing Wang
Rong Zhang
Haoling Xie
Jinsong Xu
Jie Chu
Chunmei Wei
Quanfang Chen
author_sort Xuexing Wang
collection DOAJ
description Objective The primary objective of this research was to examine the characteristics of myelosuppression following first-line chemotherapy in patients suffering from diffuse large B-cell lymphoma (DLBCL). Furthermore, the study aimed to identify and analyze the risk factors impacting myelosuppression after chemotherapy and to construct a predictive model for evaluating the risk of myelosuppression. Methods This retrospective cohort study was conducted across two medical centers. The study included 243 patients with DLBCL treated at the Anning First People’s Hospital Affiliated with Kunming University of Science and Technology from January 2022 to December 2023 as the development cohort, and 107 patients treated at the Third Affiliated Hospital of Kunming Medical University from January 2024 to May 2024 as the validation cohort. The study investigated the incidence of myelosuppression in all patients, identified independent factors influencing this condition through logistic regression analysis, and constructed and validated a nomogram. Finally, the model’s performance was evaluated using both internal and external validation cohorts. Results The research rigorously incorporated a cohort of 243 DLBCL patients, with myelosuppression observed in 93 individuals (38.27%). Multifactorial analysis revealed that the chemotherapy cycle, age, Ann Arbor stage, surgical history, and neutrophil levels were independently correlated with myelosuppression following initial chemotherapy in DLBCL patients. A nomogram was developed based on the multifactorial analysis. The receiver operating characteristic (ROC) analysis revealed myelosuppression in the nomogram of both the development set (area under the curve (AUC = 0.834, 95% CI [0.785–0.884]) and the validation set (AUC = 0.861, 95% CI [0.791–0.931])), indicating clear differentiation. Further calibration curve analysis and decision curve analysis (DCA) revealed strong calibration and clinical utility of the column-line graph model. Conclusion Patients with DLBCL are at an increased risk and frequency of myelosuppression following first-line chemotherapy. The development of a highly accurate prediction model for myelosuppression in this patient population facilitates individualized treatment strategies. Future studies should focus on expanding the sample size and developing and validating the model in additional types of cancer.
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spelling doaj-art-6b3702d4636545f69d09bffae0cd95442025-08-20T02:37:09ZengPeerJ Inc.PeerJ2167-83592025-06-0113e1953910.7717/peerj.19539Risk factors analysis and nomogram development for myelosuppression in diffuse large B-cell lymphoma patients undergoing first-line chemotherapy: a dual-centre retrospective cohort studyXuexing Wang0Rong Zhang1Haoling Xie2Jinsong Xu3Jie Chu4Chunmei Wei5Quanfang Chen6Department of Oncology, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, Yunnan, ChinaDepartment of Geriatric Oncology, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, ChinaDepartment of Oncology, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, Yunnan, ChinaDepartment of Oncology, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, Yunnan, ChinaDepartment of Oncology, Ziyang Central Hospital, Ziyang, Sichuan, ChinaDepartment of Oncology, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, Yunnan, ChinaDepartment of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, ChinaObjective The primary objective of this research was to examine the characteristics of myelosuppression following first-line chemotherapy in patients suffering from diffuse large B-cell lymphoma (DLBCL). Furthermore, the study aimed to identify and analyze the risk factors impacting myelosuppression after chemotherapy and to construct a predictive model for evaluating the risk of myelosuppression. Methods This retrospective cohort study was conducted across two medical centers. The study included 243 patients with DLBCL treated at the Anning First People’s Hospital Affiliated with Kunming University of Science and Technology from January 2022 to December 2023 as the development cohort, and 107 patients treated at the Third Affiliated Hospital of Kunming Medical University from January 2024 to May 2024 as the validation cohort. The study investigated the incidence of myelosuppression in all patients, identified independent factors influencing this condition through logistic regression analysis, and constructed and validated a nomogram. Finally, the model’s performance was evaluated using both internal and external validation cohorts. Results The research rigorously incorporated a cohort of 243 DLBCL patients, with myelosuppression observed in 93 individuals (38.27%). Multifactorial analysis revealed that the chemotherapy cycle, age, Ann Arbor stage, surgical history, and neutrophil levels were independently correlated with myelosuppression following initial chemotherapy in DLBCL patients. A nomogram was developed based on the multifactorial analysis. The receiver operating characteristic (ROC) analysis revealed myelosuppression in the nomogram of both the development set (area under the curve (AUC = 0.834, 95% CI [0.785–0.884]) and the validation set (AUC = 0.861, 95% CI [0.791–0.931])), indicating clear differentiation. Further calibration curve analysis and decision curve analysis (DCA) revealed strong calibration and clinical utility of the column-line graph model. Conclusion Patients with DLBCL are at an increased risk and frequency of myelosuppression following first-line chemotherapy. The development of a highly accurate prediction model for myelosuppression in this patient population facilitates individualized treatment strategies. Future studies should focus on expanding the sample size and developing and validating the model in additional types of cancer.https://peerj.com/articles/19539.pdfNon-Hodgkin lymphomaMyelosuppressionRiskForecastingNomograms
spellingShingle Xuexing Wang
Rong Zhang
Haoling Xie
Jinsong Xu
Jie Chu
Chunmei Wei
Quanfang Chen
Risk factors analysis and nomogram development for myelosuppression in diffuse large B-cell lymphoma patients undergoing first-line chemotherapy: a dual-centre retrospective cohort study
PeerJ
Non-Hodgkin lymphoma
Myelosuppression
Risk
Forecasting
Nomograms
title Risk factors analysis and nomogram development for myelosuppression in diffuse large B-cell lymphoma patients undergoing first-line chemotherapy: a dual-centre retrospective cohort study
title_full Risk factors analysis and nomogram development for myelosuppression in diffuse large B-cell lymphoma patients undergoing first-line chemotherapy: a dual-centre retrospective cohort study
title_fullStr Risk factors analysis and nomogram development for myelosuppression in diffuse large B-cell lymphoma patients undergoing first-line chemotherapy: a dual-centre retrospective cohort study
title_full_unstemmed Risk factors analysis and nomogram development for myelosuppression in diffuse large B-cell lymphoma patients undergoing first-line chemotherapy: a dual-centre retrospective cohort study
title_short Risk factors analysis and nomogram development for myelosuppression in diffuse large B-cell lymphoma patients undergoing first-line chemotherapy: a dual-centre retrospective cohort study
title_sort risk factors analysis and nomogram development for myelosuppression in diffuse large b cell lymphoma patients undergoing first line chemotherapy a dual centre retrospective cohort study
topic Non-Hodgkin lymphoma
Myelosuppression
Risk
Forecasting
Nomograms
url https://peerj.com/articles/19539.pdf
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