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. 2024 Mar 30;24(1):64.
doi: 10.1007/s10238-024-01326-y.

Development and validation of a novel prognostic nomogram for advanced diffuse large B cell lymphoma

Mengdi Wan #  1 , Wei Zhang #  1 , He Huang  2 , Xiaojie Fang  2 , Yungchang Chen  1 , Ying Tian  2 , Yuyi Yao  2 , Huawei Weng  2 , Zegeng Chen  2 , Le Yu  1 , Yuke Tian  1 , Huageng Huang  2 , Xudong Li  1 , Huangming Hong  3 , Tongyu Lin  4   5
Affiliations

Development and validation of a novel prognostic nomogram for advanced diffuse large B cell lymphoma

Mengdi Wan et al. Clin Exp Med. .

Abstract

Advanced diffuse large B cell lymphoma (DLBCL) is a common malignant tumor with aggressive clinical features and poor prognosis. At present, there is lack of effective prognostic tool for patients with advanced (stage III/IV) DLBCL. The aim of this study is to identify prognostic indicators that affect survival and response and establish the first survival prediction nomogram for advanced DLBCL. A total of 402 patients with advanced DLBCL were enrolled in this study. COX multivariate analysis was used to obtain independent prognostic factors. The independent prognostic factors were included in the nomogram, and the nomogram to predict the performance of the model was established by R rms package, C-index (consistency index), AUC curve and calibration curve. The training and validation cohorts included 281 and 121 patients. In the training cohort, multivariate analysis showed that Ki-67 (70% (high expression) vs ≤ 70% (low expression), p < 0.001), LDH (lactate dehydrogenase) (elevated vs normal, p = 0.05), FER (ferritin) (elevated vs normal, p < 0.001), and β2-microglobulin (elevated vs normal, p < 0.001) were independent predictors and the nomogram was constructed. The nomogram showed that there was a significant difference in OS among the low-risk, intermediate-risk and high-risk groups, with 5-year survival rates of 81.6%, 44% and 6%, respectively. The C-index of the nomogram in the training group was 0.76. The internal validation of the training group showed good consistency. In the internal validation cohort of the training group, the AUC was 0.828, and similar results were obtained in the validation group, with a C-index of 0.74 and an AUC of 0.803. The proposed nomogram provided a valuable individualized risk assessment of OS in advanced DLBCL patients.

Keywords: NHL; Nomogram; DLBCL; Prognosis.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Nomogram model based on patients in the training group
Fig. 2
Fig. 2
Kaplan–Meier survival curves for risk groups of the nomogram model in the training group
Fig. 3
Fig. 3
a Clibration curve for predicting 3-year OS of patients with advanced DLBCL in the training group. b The ROC curve of the nomogram model to predict the 3-year OS rate of patients with advanced DLBCL in the training group
Fig. 4
Fig. 4
a Calibration curve for predicting 3-year OS of advanced DLBCL patients in validation group. b ROC curve of the nomogram model predicting 3-year OS of patients with advanced DLBCL in the validation group.
Fig. 5
Fig. 5
Kaplan–Meier survival curves for IPI risk groups in the training group
Fig. 6
Fig. 6
a The IPI low and low-intermediate risk groups in the training group were included in the Kaplan–Meier survival curve of the nomogram model. b The IPI high intermediate and high-risk groups in the training group were included in the Kaplan–Meier survival curve of the nomogram model
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References

    1. Cultrera JL, Dalia SM. Diffuse large B-cell lymphoma: current strategies and future directions. Cancer Control. 2012;19(3):204–13. - PubMed
    1. Yang QP, et al. Subtype distribution of lymphomas in Southwest China: analysis of 6,382 cases using WHO classification in a single institution. Diagn Pathol. 2011;6:77. - PMC - PubMed
    1. Zelenetz AD, et al. NCCN Guidelines® insights: B-Cell lymphomas, version 5.2021. J Natl Compr Canc Netw. 2021;19(11):1218–30. - PubMed
    1. Vitolo U, et al. Extranodal diffuse large B-cell lymphoma (DLBCL) and primary mediastinal B-cell lymphoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol Off J Eur Soc Med Oncol. 2016;27:v91–102. - PubMed
    1. Susanibar-Adaniya S, Barta SK. 2021 Update on Diffuse large B cell lymphoma: a review of current data and potential applications on risk stratification and management. Am J Hematol. 2021;96(5):617–29. - PMC - PubMed

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