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Barta SK , Xue X , Wang D , Lee JY , Kaplan LD , Ribera JM , Oriol A , Spina M , Tirelli U , Boue F , Wilson WH , Wyen C , Dunleavy K , Noy A , Sparano JA
A new prognostic score for AIDS-related lymphomas in the rituximab-era
Haematologica. 2014 Nov;99(11) :1731-7
PMID: 25150257    PMCID: PMC4222464    URL: http://www.ncbi.nlm.nih.gov/pubmed/25150257
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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%).
Barta, Stefan K Xue, Xiaonan Wang, Dan Lee, Jeannette Y Kaplan, Lawrence D Ribera, Josep-Maria Oriol, Albert Spina, Michele Tirelli, Umberto Boue, Francois Wilson, Wyndham H Wyen, Christoph Dunleavy, Kieron Noy, Ariela Sparano, Joseph A ENG KL2 RR025749/RR/NCRR NIH HHS/ UL1 RR025750/RR/NCRR NIH HHS/ U01CA121947/CA/NCI NIH HHS/ K12CA132783-03/CA/NCI NIH HHS/ TL1 RR025748/RR/NCRR NIH HHS/ UL1 TR001073/TR/NCATS NIH HHS/ K12 CA132783/CA/NCI NIH HHS/ P30 CA013330/CA/NCI NIH HHS/ U01 CA121947/CA/NCI NIH HHS/ Meta-Analysis Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Italy 2014/08/26 06:00 Haematologica. 2014 Nov;99(11):1731-7. doi: 10.3324/haematol.2014.111112. Epub 2014 Aug 22.