Abstract |
While the International Prognostic Index is commonly used to predict outcomes in immunocompetent patients with aggressive B-cell non-Hodgkin lymphomas, HIV-infection is an important competing risk for death in patients with AIDS-related lymphomas. We investigated whether a newly created prognostic score ( AIDS-related lymphoma International Prognostic Index) could better assess risk of death in patients with AIDS-related lymphomas. We randomly divided a dataset of 487 patients newly diagnosed with AIDS-related lymphomas and treated with rituximab-containing chemoimmunotherapy into a training (n=244) and validation (n=243) set. We examined the association of HIV-related and other known risk factors with overall survival in both sets independently. We defined a new score ( AIDS-related lymphoma International Prognostic Index) by assigning weights to each significant predictor [age-adjusted International Prognostic Index, extranodal sites, HIV-score (composed of CD4 count, viral load, and prior history of AIDS)] with three risk categories similar to the age-adjusted International Prognostic Index (low, intermediate and high risk). We compared the prognostic value for overall survival between AIDS-related lymphoma International Prognostic Index and age-adjusted International Prognostic Index in the validation set and found that the AIDS-related lymphoma International Prognostic Index performed significantly better in predicting risk of death than the age-adjusted International Prognostic Index (P=0.004) and better discriminated risk of death between each risk category (P=0.015 vs. P=0.13). Twenty-eight percent of patients were defined as low risk by the ARL-IPI and had an estimated 5-year overall survival (OS) of 78% (52% intermediate risk, 5-year OS 60%; 20% high risk, 5-year OS 50%).
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Authors | Stefan K Barta, Xiaonan Xue, Dan Wang, Jeannette Y Lee, Lawrence D Kaplan, Josep-Maria Ribera, Albert Oriol, Michele Spina, Umberto Tirelli, Francois Boue, Wyndham H Wilson, Christoph Wyen, Kieron Dunleavy, Ariela Noy, Joseph A Sparano |
Journal | Haematologica
(Haematologica)
Vol. 99
Issue 11
Pg. 1731-7
(Nov 2014)
ISSN: 1592-8721 [Electronic] Italy |
PMID | 25150257
(Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright© Ferrata Storti Foundation. |
Chemical References |
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents
- Rituximab
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Topics |
- Adult
- Antibodies, Monoclonal, Murine-Derived
(therapeutic use)
- Antineoplastic Agents
(therapeutic use)
- CD4 Lymphocyte Count
- Clinical Trials as Topic
- Female
- Humans
- Lymphoma, AIDS-Related
(diagnosis, drug therapy, mortality)
- Male
- Middle Aged
- Prognosis
- Rituximab
- Treatment Outcome
- Viral Load
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