Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma

Aim. To develop an integrated prognostic model of diffuse large B-cell lymphoma (DLBCL) on the basis of immunohistochemical tumor subtype and parameters of International Prognostic Index (IPI). Materials & Methods. Out of 104 DLBCL patients in the data base 81 (77.9 %) met the eligibility crite...

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Main Authors: SV Samarina, AS Luchinin, NV Minaeva, IV Paramonov, DA D’yakonov, EV Vaneeva, VA Rosin
Format: Article
Language:Russian
Published: Practical Medicine Publishing House 2019-09-01
Series:Клиническая онкогематология
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Online Access: http://bloodjournal.ru/wp-content/uploads/2019/09/3-1.pdf
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author SV Samarina
AS Luchinin
NV Minaeva
IV Paramonov
DA D’yakonov
EV Vaneeva
VA Rosin
VA Rosin
author_facet SV Samarina
AS Luchinin
NV Minaeva
IV Paramonov
DA D’yakonov
EV Vaneeva
VA Rosin
VA Rosin
author_sort SV Samarina
collection DOAJ
description Aim. To develop an integrated prognostic model of diffuse large B-cell lymphoma (DLBCL) on the basis of immunohistochemical tumor subtype and parameters of International Prognostic Index (IPI). Materials & Methods. Out of 104 DLBCL patients in the data base 81 (77.9 %) met the eligibility criteria. Median age was 58 years (range 23–83). All patients were treated with R-СНОР. The creation of overall survival (OS) prognostic model for DLBCL patients was based on machine learning with classification and regression trees. OS was analyzed using Kaplan-Meier method. Survival curves were compared by means of log rank test and hazard ratio (HR). Any test was considered significant if two-sided level of p < 0.05 was reached. Results. Following the developed model three groups of patients were identified: the 1st group of low risk (the combination of low, intermediate-low, and intermediate-high risks according to IPI and GCB subtype); the 2nd group of intermediate risk (the combination of low, intermediate-low, and intermediate-high risks according to IPI and non-GCB subtype); the 3d group of high risk (irrespective of subtype). In the group of low risk (n = 26) 2-year OS during the monitoring period was 100 %. In the group of intermediate risk (n = 34) median OS was not reached, 2-year OS was 74 %, and expected 5-year OS was 68 %. In the group of high risk (n = 21) median OS was 25 months, 2-year OS was 46 %, and expected 5-year OS was 37 % (log rank p < 0.0001). HR calculated for the high-risk group compared with the low- and intermediate-risk groups was 5.1 (95% CI 2.1–12.1; p = 0.0003). Conclusion. A new integrated system of DLBCL prognosis is suggested which includes IPI risk parameters and immunohistochemical subtype based on Hans algorithm. This prognostic system can be used in clinical practice for DLBCL patient stratification and risk-adapted therapy.
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spelling doaj-art-c859be81385e415aa6ef60c82c2cfdb82025-08-20T03:24:03ZrusPractical Medicine Publishing HouseКлиническая онкогематология1997-69332500-21392019-09-0112438539010.21320/2500-2139-2019-12-4-385-39019976933Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell LymphomaSV Samarina0AS Luchinin1NV Minaeva2IV Paramonov3DA D’yakonov4EV Vaneeva5VA Rosin6VA Rosin7 Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027 Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027 Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027 Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027 Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027 Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027 Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027 Russian Research Institute of Hematology and Transfusiology, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024 Aim. To develop an integrated prognostic model of diffuse large B-cell lymphoma (DLBCL) on the basis of immunohistochemical tumor subtype and parameters of International Prognostic Index (IPI). Materials & Methods. Out of 104 DLBCL patients in the data base 81 (77.9 %) met the eligibility criteria. Median age was 58 years (range 23–83). All patients were treated with R-СНОР. The creation of overall survival (OS) prognostic model for DLBCL patients was based on machine learning with classification and regression trees. OS was analyzed using Kaplan-Meier method. Survival curves were compared by means of log rank test and hazard ratio (HR). Any test was considered significant if two-sided level of p < 0.05 was reached. Results. Following the developed model three groups of patients were identified: the 1st group of low risk (the combination of low, intermediate-low, and intermediate-high risks according to IPI and GCB subtype); the 2nd group of intermediate risk (the combination of low, intermediate-low, and intermediate-high risks according to IPI and non-GCB subtype); the 3d group of high risk (irrespective of subtype). In the group of low risk (n = 26) 2-year OS during the monitoring period was 100 %. In the group of intermediate risk (n = 34) median OS was not reached, 2-year OS was 74 %, and expected 5-year OS was 68 %. In the group of high risk (n = 21) median OS was 25 months, 2-year OS was 46 %, and expected 5-year OS was 37 % (log rank p < 0.0001). HR calculated for the high-risk group compared with the low- and intermediate-risk groups was 5.1 (95% CI 2.1–12.1; p = 0.0003). Conclusion. A new integrated system of DLBCL prognosis is suggested which includes IPI risk parameters and immunohistochemical subtype based on Hans algorithm. This prognostic system can be used in clinical practice for DLBCL patient stratification and risk-adapted therapy. http://bloodjournal.ru/wp-content/uploads/2019/09/3-1.pdf diffuse large b-cell lymphomaoverall survivalprognosisinternational prognostic indexmachine learning
spellingShingle SV Samarina
AS Luchinin
NV Minaeva
IV Paramonov
DA D’yakonov
EV Vaneeva
VA Rosin
VA Rosin
Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma
Клиническая онкогематология
diffuse large b-cell lymphoma
overall survival
prognosis
international prognostic index
machine learning
title Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma
title_full Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma
title_fullStr Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma
title_full_unstemmed Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma
title_short Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma
title_sort immunohistochemical subtype and parameters of international prognostic index in the new prognostic model of diffuse large b cell lymphoma
topic diffuse large b-cell lymphoma
overall survival
prognosis
international prognostic index
machine learning
url http://bloodjournal.ru/wp-content/uploads/2019/09/3-1.pdf
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