State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China.
Jiangsu Institute of Hematology, Institute of Blood and Marrow Transplantation, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
EBioMedicine. 2019 Mar;41:167-174. doi: 10.1016/j.ebiom.2019.02.048. Epub 2019 Mar 1.
This study aimed to investigate the association of pre-treatment inflammatory status with survival time and to develop a prognostic nomogram incorporating inflammatory cytokines in non-Hodgkin's lymphoma.
A total of 228 patients with diffuse large B-cell lymphoma (DLBCL) received R-CHOP-based regimens from a prospective randomized study (NCT01852435) were included as a training cohort. Other cohorts of 886 lymphoma patients were served as validation cohorts. Lymphocyte-monocyte ratio (LMR), serum levels of soluble interleukin s(IL)-2R, IL-6, IL-8, IL-10 and tumor necrosis factor-α (TNF-α), were assessed before treatment. Least absolute shrinkage and selection operator (LASSO) regression were used to select variables for nomogram of overall survival (OS). The predictive accuracy of the nomogram was determined by concordance index (C-index).
The nomogram included lactate dehydrogenase (LDH), sIL-2R, TNF-α and decreased LMR. The C-index of the nomogram for OS prediction were range from 0.61 to 0.86 for training cohort of DLBCL and validation cohorts of DLBCL, PTCL, NKTCL and ASCT, which were superior to the predictive power of International Prognostic Index (IPI, 0.67 to 0.84) or NCCN-IPI (0.59 to 0.78), but not in those of indolent lymphoma like FL and MALT.
The nomogram incorporating inflammatory cytokines provides a useful tool for risk stratification in aggressive non-Hodgkin's lymphomas. FUND: National Natural Science Foundation of China, the Shanghai Commission of Science and Technology, Multicenter Clinical Research Project by Shanghai Jiao Tong University School of Medicine, Clinical Research Plan of SHDC, and Chang Jiang Scholars Program.
本研究旨在探讨治疗前炎症状态与生存时间的关系，并建立一个包含炎症细胞因子的非霍奇金淋巴瘤预后列线图。
共纳入 228 例接受 R-CHOP 方案治疗的弥漫性大 B 细胞淋巴瘤（DLBCL）患者，作为前瞻性随机研究（NCT01852435）的训练队列。另外 886 例淋巴瘤患者作为验证队列。治疗前评估淋巴细胞-单核细胞比值（LMR）、可溶性白细胞介素 2 受体（sIL-2R）、白细胞介素 6（IL-6）、白细胞介素 8（IL-8）、白细胞介素 10（IL-10）和肿瘤坏死因子-α（TNF-α）的血清水平。使用最小绝对收缩和选择算子（LASSO）回归选择列线图总体生存（OS）的变量。通过一致性指数（C-index）确定列线图的预测准确性。
列线图包括乳酸脱氢酶（LDH）、sIL-2R、TNF-α和降低的 LMR。DLBCL 训练队列和 DLBCL、PTCL、NKTCL 和 ASCT 验证队列的 OS 预测列线图的 C-index 范围为 0.61 至 0.86，优于国际预后指数（IPI，0.67 至 0.84）或 NCCN-IPI（0.59 至 0.78）的预测能力，但在惰性淋巴瘤（如 FL 和 MALT）中则不然。
纳入炎症细胞因子的列线图为侵袭性非霍奇金淋巴瘤的风险分层提供了一个有用的工具。
国家自然科学基金、上海市科委、上海交通大学医学院多中心临床研究项目、上海市科委临床研究计划和长江学者奖励计划。
