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Haematologica. 2014 Nov;99(11):1731-7. doi: 10.3324/haematol.2014.111112. Epub 2014 Aug 22.

A new prognostic score for AIDS-related lymphomas in the rituximab-era.

Author information

1
Fox Chase Cancer Center, Philadelphia, PA, USA Stefan.Barta@fccc.ed.
2
Albert Einstein Cancer Center, Bronx, NY, USA.
3
University of Arkansas, Little Rock, AR, USA.
4
University of California, San Francisco, CA, USA.
5
ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute and PETHEMA Group, Badalona, Spain.
6
National Cancer Institute, Aviano, Italy.
7
Hopital Antoine Beclere, Clamart, France.
8
National Cancer Institute, Bethesda, MD, USA.
9
University Hospital Cologne, Germany.
10
Memorial-Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA.

Abstract

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%).

PMID:
25150257
PMCID:
PMC4222464
DOI:
10.3324/haematol.2014.111112
[Indexed for MEDLINE]
Free PMC Article

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