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新型药物治疗原发性浆细胞白血病患者的临床预后模型的开发:一项多中心回顾性队列研究。

Development of a clinical prognostic model for primary plasma cell leukemia patients treated with novel agents: a multicenter retrospective cohort study.

机构信息

Department of Hematology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, China.

Department of Hematology, Second Hospital of Shanxi Medical University, Taiyuan, China.

出版信息

Ann Hematol. 2024 Sep;103(9):3691-3699. doi: 10.1007/s00277-024-05862-1. Epub 2024 Jul 29.

Abstract

The prognosis of primary plasma cell leukemia (pPCL) is poor, and the relevant prognostic factors are incompletely understood. We aimed to explore the prognostic factors and develop a validated prognostic prediction model for pPCL patients in the new era. This multicenter retrospective study was conducted across 16 hospitals in China. Cox proportional hazards regression analysis was used to develop a prediction model. The predictive performance of the model was assessed using multiple metrics. Internal validation was conducted using bootstrap resampling. A total of 102 pPCL patients were included in this study, and 57 (55.9%) were male. The 12-month, 24-month, and 36-month OS rates for pPCL patients were 75.4%, 58.3%, and 47.6%, respectively. An overall survival prognostic nomogram for pPCL patients was established by integrating independent prognostic factors, including age, B2MG, and del17p. The nomogram exhibited good performance, with a C-index of 0.720 (95% CI 0.642-0.797) and an AUC of 0.653. Bootstrap validation yielded a C-index of 0.721 (95% CI 0.629-0.787) and an AUC of 0.653 (95% CI 0.546-0.759), indicating a relatively good fit of the calibration curve. A nomogram incorporating age, B2MG grade, and del17p were developed and validated to accurately and consistently predict the prognosis of pPCL patients.

摘要

原发性浆细胞白血病(pPCL)的预后较差,相关预后因素尚未完全阐明。本研究旨在探讨 pPCL 患者的预后因素,并建立一种适用于新时代的 pPCL 患者的验证预后预测模型。本多中心回顾性研究共纳入中国 16 家医院的 102 例 pPCL 患者。采用 Cox 比例风险回归分析建立预测模型。采用多种指标评估模型的预测性能。采用自举重采样进行内部验证。本研究共纳入 102 例 pPCL 患者,其中 57 例(55.9%)为男性。pPCL 患者的 12 个月、24 个月和 36 个月 OS 率分别为 75.4%、58.3%和 47.6%。通过整合独立的预后因素,包括年龄、B2MG 和 del17p,建立了一个用于预测 pPCL 患者总体生存的列线图。该列线图具有良好的性能,C 指数为 0.720(95%CI 0.642-0.797),AUC 为 0.653。自举验证的 C 指数为 0.721(95%CI 0.629-0.787),AUC 为 0.653(95%CI 0.546-0.759),表明校准曲线拟合较好。建立并验证了一个包含年龄、B2MG 分级和 del17p 的列线图,以准确且一致地预测 pPCL 患者的预后。

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