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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

Cumulative risk of death according to occurrence of AIDS defining event and PNI. The low-risk group included patients without AIDS defining event within six months from NHL diagnosis and with PNI > 45; the intermediate-risk group included patients with AIDS defining event within six months from data of NHL diagnosis or with PNI < 45; and the high-risk group included patient with AIDS defining event within six months from NHL diagnosis and with PNI < 45.
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Fig2: Cumulative risk of death according to occurrence of AIDS defining event and PNI. The low-risk group included patients without AIDS defining event within six months from NHL diagnosis and with PNI > 45; the intermediate-risk group included patients with AIDS defining event within six months from data of NHL diagnosis or with PNI < 45; and the high-risk group included patient with AIDS defining event within six months from NHL diagnosis and with PNI < 45.

Mentions: The linear prediction equation for risk of mortality (Rm) derived from the final Cox model was: Rm = 0. 703 *(occurrence of AIDS defining event within six months from NHL diagnosis [yes =1/no = 0]) + 0.794* (PNI). The predictive accuracies of this risk score for mortality, as measured by the AUC, were 0.69 (95% CI 0.58 to 0.81) and 0.69 (0.57 to 0.81) in derivation sample, and 0.69 (0.49 to 0.90) and 0.73 (0.53 to 0.92) in validation sample (47 subjects with PNI available, 12 of which died), at 3 and 5 years of follow-up, respectively. As an application of the score, patients were categorized into three risk groups: patients without AIDS defining event within six months from the date of NHL diagnosis and with PNI > 45, patients with AIDS defining event within six months from the date of NHL diagnosis or with PNI < 45 and patients with AIDS defining event within six months from the date of NHL diagnosis and with PNI < 45. According to the 3 risk score categories, cumulative mortality rates were 20.8% (10.4 to 38.9), 31.8% (18.8 to 50.3) and 64.5% (43.3 to 84.8) in the low-, intermediate- and high-risk group (log rank test p < 0.001) (Figure 2).Figure 2


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)

Cumulative risk of death according to occurrence of AIDS defining event and PNI. The low-risk group included patients without AIDS defining event within six months from NHL diagnosis and with PNI > 45; the intermediate-risk group included patients with AIDS defining event within six months from data of NHL diagnosis or with PNI < 45; and the high-risk group included patient with AIDS defining event within six months from NHL diagnosis and with PNI < 45.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig2: Cumulative risk of death according to occurrence of AIDS defining event and PNI. The low-risk group included patients without AIDS defining event within six months from NHL diagnosis and with PNI > 45; the intermediate-risk group included patients with AIDS defining event within six months from data of NHL diagnosis or with PNI < 45; and the high-risk group included patient with AIDS defining event within six months from NHL diagnosis and with PNI < 45.
Mentions: The linear prediction equation for risk of mortality (Rm) derived from the final Cox model was: Rm = 0. 703 *(occurrence of AIDS defining event within six months from NHL diagnosis [yes =1/no = 0]) + 0.794* (PNI). The predictive accuracies of this risk score for mortality, as measured by the AUC, were 0.69 (95% CI 0.58 to 0.81) and 0.69 (0.57 to 0.81) in derivation sample, and 0.69 (0.49 to 0.90) and 0.73 (0.53 to 0.92) in validation sample (47 subjects with PNI available, 12 of which died), at 3 and 5 years of follow-up, respectively. As an application of the score, patients were categorized into three risk groups: patients without AIDS defining event within six months from the date of NHL diagnosis and with PNI > 45, patients with AIDS defining event within six months from the date of NHL diagnosis or with PNI < 45 and patients with AIDS defining event within six months from the date of NHL diagnosis and with PNI < 45. According to the 3 risk score categories, cumulative mortality rates were 20.8% (10.4 to 38.9), 31.8% (18.8 to 50.3) and 64.5% (43.3 to 84.8) in the low-, intermediate- and high-risk group (log rank test p < 0.001) (Figure 2).Figure 2

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