{"title":"A promising prognostic model for patients with AIDS-related lymphoma in the cART era.","authors":"Guang-Wei Yang, Qi-Wen Zhou, Xin Zhen, Ying Yang, Yuan-Lu Shu, Hao Sun, Hai-Yan Min, Xi-Cheng Wang","doi":"10.1097/QAD.0000000000004197","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>For patients with AIDS-related lymphoma (ARL), optimizing risk stratification is crucial to creating customized therapy regimens and enhancing their prognosis. This study aims to develop a more precisely predicted prognostic model for ARL patients.</p><p><strong>Design: </strong>A 7-year retrospective cohort study (2016-2023) of 136 ARL patients at a single institution randomly allocated training (n = 109) and validation (n = 27) cohorts.</p><p><strong>Methods: </strong>We assessed the relationship between HIV, lymphoma, and patient-specific factors and overall survival (OS) and progression-free survival (PFS) by univariate and multivariate analyses.</p><p><strong>Results: </strong>The median age was 48(IQR: 40-56) years, 76.5% were men. The overall 2-year OS and PFS were 52.9% and 48.5%, respectively. In the multivariate analysis, Eastern Cooperative Oncology Group performance status (ECOG-PS), Central nervous system (CNS) involvement, elevated lactate dehydrogenase (LDH), Hemoglobin (Hb), neutrophil-lymphocyte ratio (NLR), and chemotherapy cycles were independently related to overall survival (OS). A new prognosis score was generated with these variables including ECOG ≥2, CNS involvement, elevated LDH, Hb<130 g/L, NLR>5 and not exceeding 5 chemotherapy cycles, with 1 point for each variable, for a maximum of 6. The area under the curve and C-index of the new model were 0.79 and 0.76, respectively. Our model showed better risk stratification in ARL patients than aaIPI, NCCN-IPI, and ARL-IPI.</p><p><strong>Conclusions: </strong>In this study, we created a prognostic model for ARL patients that is clinically straightforward, feasible, and has good predictive power. Compared to the NCCN-IPI and the aaIPI, this model is more discriminative and predictively accurate in risk stratification and high-risk population identification.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004197","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: For patients with AIDS-related lymphoma (ARL), optimizing risk stratification is crucial to creating customized therapy regimens and enhancing their prognosis. This study aims to develop a more precisely predicted prognostic model for ARL patients.
Design: A 7-year retrospective cohort study (2016-2023) of 136 ARL patients at a single institution randomly allocated training (n = 109) and validation (n = 27) cohorts.
Methods: We assessed the relationship between HIV, lymphoma, and patient-specific factors and overall survival (OS) and progression-free survival (PFS) by univariate and multivariate analyses.
Results: The median age was 48(IQR: 40-56) years, 76.5% were men. The overall 2-year OS and PFS were 52.9% and 48.5%, respectively. In the multivariate analysis, Eastern Cooperative Oncology Group performance status (ECOG-PS), Central nervous system (CNS) involvement, elevated lactate dehydrogenase (LDH), Hemoglobin (Hb), neutrophil-lymphocyte ratio (NLR), and chemotherapy cycles were independently related to overall survival (OS). A new prognosis score was generated with these variables including ECOG ≥2, CNS involvement, elevated LDH, Hb<130 g/L, NLR>5 and not exceeding 5 chemotherapy cycles, with 1 point for each variable, for a maximum of 6. The area under the curve and C-index of the new model were 0.79 and 0.76, respectively. Our model showed better risk stratification in ARL patients than aaIPI, NCCN-IPI, and ARL-IPI.
Conclusions: In this study, we created a prognostic model for ARL patients that is clinically straightforward, feasible, and has good predictive power. Compared to the NCCN-IPI and the aaIPI, this model is more discriminative and predictively accurate in risk stratification and high-risk population identification.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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