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The prognostic role of systemic inflammatory markers on HIV-infected patients with non-Hodgkin lymphoma, a multicenter cohort study.

Raffetti E, Donato F, Castelnuovo F, Ladisa N, Paraninfo G, Di Filippo E, Segala D, Cologni G, Bandera A, Zacchi F, Digiambenedetto S, Di Pietro M, Castelli F, Quiros-Roldan E, MASTER Coho - J Transl Med (2015)

Bottom Line: GPS, mGPS, PI and PNI were independently associated with risk of death.The AUCs were 0.69 (95% CI 0.58 to 0.81) and 0.69 (95% CI 0.57 to 0.81) at 3 and 5 years of the follow-up, respectively.GPS, mGPS, PI and PNI are independent prognostic factors for survival of HIV patients with NHL.

View Article: PubMed Central - PubMed

Affiliation: Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy. e.raffetti@unibs.it.

ABSTRACT

Background: The systemic inflammatory response has been postulated as having prognostic significance in a wide range of different cancer types. We aimed to assess the prognostic role of inflammatory markers on survival in HIV-infected patients with Non-Hodgkin Lymphoma (NHL), and to compute a prognostic score based on inflammatory biomarkers.

Methods: We evaluated data on HIV patients with NLH diagnosis between 1998 and 2012 in a HIV Italian Cohort. Using Cox proportional regression model, we assessed the prognostic role of Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), and Prognostic Nutritional Index (PNI). We also computed a risk score equation, assigning patients to a derivation and a validation sample. The area under the curve (AUC) was use to evaluate the predictive ability of this score.

Results: 215 non-Hodgkin lymphoma cases (80.0% males) with a mean age of 43.2 years were included. Deaths were observed in 98 (45.6%) patients during a median follow up of 5 years. GPS, mGPS, PI and PNI were independently associated with risk of death. We also computed a mortality risk score which included PNI and occurrence of an AIDS event within six months from NHL diagnosis. The AUCs were 0.69 (95% CI 0.58 to 0.81) and 0.69 (95% CI 0.57 to 0.81) at 3 and 5 years of the follow-up, respectively.

Conclusions: GPS, mGPS, PI and PNI are independent prognostic factors for survival of HIV patients with NHL.

No MeSH data available.


Related in: MedlinePlus

The relationship between the inflammatory-based prognostic scores considered as continuous (PLR (B), NLR (A) and PNI (C)), and the hazard ratio of death (HR). The HRs were computed in Cox regression models with cubic spline term for each prognostic score adjusted for gender, age at diagnosis, intravenous drug use, AIDS defining event, CD4 cell count, cART therapy prescription and HIV-RNA undetectable. The reference value for each spline term is 3 for NLR, 150 for PLR and 45 for PNI.
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Fig1: The relationship between the inflammatory-based prognostic scores considered as continuous (PLR (B), NLR (A) and PNI (C)), and the hazard ratio of death (HR). The HRs were computed in Cox regression models with cubic spline term for each prognostic score adjusted for gender, age at diagnosis, intravenous drug use, AIDS defining event, CD4 cell count, cART therapy prescription and HIV-RNA undetectable. The reference value for each spline term is 3 for NLR, 150 for PLR and 45 for PNI.

Mentions: Non-linear relationships between NLR, PLR, PNI and risk of death were evaluated by using multivariate Cox regression models with a restricted cubic-spline for each prognostic score (Figure 1). A trend of increasing risk of death with increasing PNI was observed, although not statistical significant, whereas no trend with PLR and NLR was found.Figure 1


The prognostic role of systemic inflammatory markers on HIV-infected patients with non-Hodgkin lymphoma, a multicenter cohort study.

Raffetti E, Donato F, Castelnuovo F, Ladisa N, Paraninfo G, Di Filippo E, Segala D, Cologni G, Bandera A, Zacchi F, Digiambenedetto S, Di Pietro M, Castelli F, Quiros-Roldan E, MASTER Coho - J Transl Med (2015)

The relationship between the inflammatory-based prognostic scores considered as continuous (PLR (B), NLR (A) and PNI (C)), and the hazard ratio of death (HR). The HRs were computed in Cox regression models with cubic spline term for each prognostic score adjusted for gender, age at diagnosis, intravenous drug use, AIDS defining event, CD4 cell count, cART therapy prescription and HIV-RNA undetectable. The reference value for each spline term is 3 for NLR, 150 for PLR and 45 for PNI.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4562103&req=5

Fig1: The relationship between the inflammatory-based prognostic scores considered as continuous (PLR (B), NLR (A) and PNI (C)), and the hazard ratio of death (HR). The HRs were computed in Cox regression models with cubic spline term for each prognostic score adjusted for gender, age at diagnosis, intravenous drug use, AIDS defining event, CD4 cell count, cART therapy prescription and HIV-RNA undetectable. The reference value for each spline term is 3 for NLR, 150 for PLR and 45 for PNI.
Mentions: Non-linear relationships between NLR, PLR, PNI and risk of death were evaluated by using multivariate Cox regression models with a restricted cubic-spline for each prognostic score (Figure 1). A trend of increasing risk of death with increasing PNI was observed, although not statistical significant, whereas no trend with PLR and NLR was found.Figure 1

Bottom Line: GPS, mGPS, PI and PNI were independently associated with risk of death.The AUCs were 0.69 (95% CI 0.58 to 0.81) and 0.69 (95% CI 0.57 to 0.81) at 3 and 5 years of the follow-up, respectively.GPS, mGPS, PI and PNI are independent prognostic factors for survival of HIV patients with NHL.

View Article: PubMed Central - PubMed

Affiliation: Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy. e.raffetti@unibs.it.

ABSTRACT

Background: The systemic inflammatory response has been postulated as having prognostic significance in a wide range of different cancer types. We aimed to assess the prognostic role of inflammatory markers on survival in HIV-infected patients with Non-Hodgkin Lymphoma (NHL), and to compute a prognostic score based on inflammatory biomarkers.

Methods: We evaluated data on HIV patients with NLH diagnosis between 1998 and 2012 in a HIV Italian Cohort. Using Cox proportional regression model, we assessed the prognostic role of Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), and Prognostic Nutritional Index (PNI). We also computed a risk score equation, assigning patients to a derivation and a validation sample. The area under the curve (AUC) was use to evaluate the predictive ability of this score.

Results: 215 non-Hodgkin lymphoma cases (80.0% males) with a mean age of 43.2 years were included. Deaths were observed in 98 (45.6%) patients during a median follow up of 5 years. GPS, mGPS, PI and PNI were independently associated with risk of death. We also computed a mortality risk score which included PNI and occurrence of an AIDS event within six months from NHL diagnosis. The AUCs were 0.69 (95% CI 0.58 to 0.81) and 0.69 (95% CI 0.57 to 0.81) at 3 and 5 years of the follow-up, respectively.

Conclusions: GPS, mGPS, PI and PNI are independent prognostic factors for survival of HIV patients with NHL.

No MeSH data available.


Related in: MedlinePlus