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<p>Despite advancements in antiretroviral therapy, AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) remains a major cause of morbidity and mortality. Compared to non-HIV-infected individuals, AR-DLBCL presents with considerable disease heterogeneity, which impairs the accuracy of current prognostic tools. This study aims to develop a novel prognostic model to enhance risk assessment for AR-DLBCL. We retrospectively analyzed 90 AR-DLBCL cases using univariate and multivariate analyses to identify clinical factors affecting overall survival (OS) and progression-free survival (PFS). A nomogram was created based on independent OS risk factors. The cohort had a median age of 43&#xa0;years (range: 22–75), with 96.5% male patients. The median follow-up was 30&#xa0;months (range: 1–139), with 5-year OS and PFS rates of 60.7% and 58.7%, respectively. Key prognostic factors for OS included decreased absolute lymphocyte count (<i>p</i> = 0.002), extranodal involvement (<i>p</i> = 0.005), reduced hemoglobin (Hb) levels (<i>p</i> = 0.004), Epstein-Barr virus (EBV) infection (<i>p</i> = 0.005), and elevated lactate dehydrogenase (LDH) levels (<i>p</i> = 0.018). The nomogram demonstrated robust predictive performance, with a 5-year receiver operating characteristic curve area under the curve of 0.949. Its C-index of 0.849 surpassed the International Prognostic Index (IPI) and age-adjusted IPI (aaIPI), which had C-index of 0.708 and 0.693, respectively. Additionally, the nomogram identified significant OS differences among low risk, intermediate-low risk, intermediate-high risk, and high-risk groups, with 5-year survival rates of 100%, 88%, 56%, and 8%, respectively. The model offers a personalized risk assessment for AR-DLBCL patients, facilitating precise prognosis prediction and informing individualized treatment strategies.</p>

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Development of a novel prognostic nomogram for AIDS-associated diffuse large B-cell lymphoma: a retrospective study from northern China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月18日

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  • Ying Liang,
  • Jing Chang,
  • Yuxue Gao,
  • Ling Zhang,
  • Xue Chen,
  • Caopei Zheng,
  • Yuqing Sun,
  • Xiuqun Zhang,
  • Caiping Guo,
  • Yulin Zhang

摘要

Despite advancements in antiretroviral therapy, AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) remains a major cause of morbidity and mortality. Compared to non-HIV-infected individuals, AR-DLBCL presents with considerable disease heterogeneity, which impairs the accuracy of current prognostic tools. This study aims to develop a novel prognostic model to enhance risk assessment for AR-DLBCL. We retrospectively analyzed 90 AR-DLBCL cases using univariate and multivariate analyses to identify clinical factors affecting overall survival (OS) and progression-free survival (PFS). A nomogram was created based on independent OS risk factors. The cohort had a median age of 43 years (range: 22–75), with 96.5% male patients. The median follow-up was 30 months (range: 1–139), with 5-year OS and PFS rates of 60.7% and 58.7%, respectively. Key prognostic factors for OS included decreased absolute lymphocyte count (p = 0.002), extranodal involvement (p = 0.005), reduced hemoglobin (Hb) levels (p = 0.004), Epstein-Barr virus (EBV) infection (p = 0.005), and elevated lactate dehydrogenase (LDH) levels (p = 0.018). The nomogram demonstrated robust predictive performance, with a 5-year receiver operating characteristic curve area under the curve of 0.949. Its C-index of 0.849 surpassed the International Prognostic Index (IPI) and age-adjusted IPI (aaIPI), which had C-index of 0.708 and 0.693, respectively. Additionally, the nomogram identified significant OS differences among low risk, intermediate-low risk, intermediate-high risk, and high-risk groups, with 5-year survival rates of 100%, 88%, 56%, and 8%, respectively. The model offers a personalized risk assessment for AR-DLBCL patients, facilitating precise prognosis prediction and informing individualized treatment strategies.