Proposed New Dynamic Prognostic Index for Diffuse Large B-Cell Lymphoma: International Metabolic Prognostic Index: International Metabolic Prognostic Index

Autor: Mikhaeel, N. George, Heymans, Martijn W., Eertink, Jakoba J., de Vet, Henrica C. W., Boellaard, Ronald, Duhrsen, Ulrich, Ceriani, Luca, Schmitz, Christine, Wiegers, Sanne E., Huttmann, Andreas, Lugtenburg, Pieternella J., Zucca, Emanuele, Zwezerijnen, Gerben J. C., Hoekstra, Otto S., Zijlstra, Josee M., Barrington, Sally F.
Přispěvatelé: Epidemiology and Data Science, APH - Methodology, APH - Personalized Medicine, Hematology laboratory, Radiology and nuclear medicine, Amsterdam Neuroscience - Brain Imaging, CCA - Imaging and biomarkers, Hematology
Jazyk: angličtina
Rok vydání: 2022
Zdroj: Journal of Clinical Oncology, 40(21), 2352-+. American Society of Clinical Oncology
Mikhaeel, N G, Heymans, M W, Eertink, J J, de Vet, H C W, Boellaard, R, Duhrsen, U, Ceriani, L, Schmitz, C, Wiegers, S E, Huttmann, A, Lugtenburg, P J, Zucca, E, Zwezerijnen, G J C, Hoekstra, O S, Zijlstra, J M & Barrington, S F 2022, ' Proposed New Dynamic Prognostic Index for Diffuse Large B-Cell Lymphoma: International Metabolic Prognostic Index : International Metabolic Prognostic Index ', Journal of Clinical Oncology, vol. 40, no. 21, pp. 2352-+ . https://doi.org/10.1200/JCO.21.02063, https://doi.org/10.1200/JCO.21.02063
ISSN: 0732-183X
DOI: 10.1200/JCO.21.02063
Popis: PURPOSEBaseline metabolic tumor volume (MTV) is a promising biomarker in diffuse large B-cell lymphoma (DLBCL). Our aims were to determine the best statistical relationship between MTV and survival and to compare MTV with the International Prognostic Index (IPI) and its individual components to derive the best prognostic model.METHODSPET scans and clinical data were included from five published studies in newly diagnosed diffuse large B-cell lymphoma. Transformations of MTV were compared with the primary end points of 3-year progression-free survival (PFS) and overall survival (OS) to derive the best relationship for further analyses. MTV was compared with IPI categories and individual components to derive the best model. Patients were grouped into three groups for survival analysis using Kaplan-Meier analysis; 10% at highest risk, 30% intermediate risk, and 60% lowest risk, corresponding with expected clinical outcome. Validation of the best model was performed using four studies as a test set and the fifth study for validation and repeated five times.RESULTSThe best relationship for MTV and survival was a linear spline model with one knot located at the median MTV value of 307.9 cm3. MTV was a better predictor than IPI for PFS and OS. The best model combined MTV with age as continuous variables and individual stage as I-IV. The MTV-age-stage model performed better than IPI and was also better at defining a high-risk group (3-year PFS 46.3% v 58.0% and 3-year OS 51.5% v 66.4% for the new model and IPI, respectively). A regression formula was derived to estimate individual patient survival probabilities.CONCLUSIONA new prognostic index is proposed using MTV, age, and stage, which outperforms IPI and enables individualized estimates of patient outcome.
Databáze: OpenAIRE