1
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Roberts WS, Delladio W, Price S, Murawski A, Nguyen H. The efficacy of albumin-globulin ratio to predict prognosis in cancer patients. Int J Clin Oncol 2023; 28:1101-1111. [PMID: 37421476 DOI: 10.1007/s10147-023-02380-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
The goal of this systematic review was to identify all of the research within the last 10 years that investigated both the Albumin-Globulin Ratio (AGR) and outcomes of solid tumor cancer patients via quantitative prognostic variables. Multiple scientific databases were researched for journal articles that included keywords relating AGR to prognosis. Once isolated from the databases, the articles were de-duplicated and manually screened based on standardized inclusion/exclusion criteria in a blind format via Rayyan. The collective data were sorted by cancer type, corrected for population size, and used to calculate the average cut-off values for the most popular prognostic variables. In total, 18 independent types of cancer have been evaluated to see if AGR is a prognostic indicator based on multivariate analyses. The average cut-off value for AGR in overall survival was 1.356, while the average cut-off value for AGR in progression free survival was 1.292. AGR was found to be significantly associated with at least one prognostic variable in every type of cancer evaluated based on multivariate analyses. The ease of access and affordability of AGR makes it an invaluable tool applicable to nearly all patients. Overall, AGR is a proven prognostic variable that should always be considered in the evaluation of a solid tumor cancer patient's prognosis. Further research needs to be conducted studying the potential prognostic effect in more types of solid tumors.
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Affiliation(s)
- Will S Roberts
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA.
| | - William Delladio
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Shawn Price
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Alec Murawski
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
| | - Hoang Nguyen
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL, 33759, USA
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2
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Lu C, Chen Q, Fei L, Wang J, Wang C, Yu L. Prognostic impact of the controlling nutritional status score in patients with hematologic malignancies: A systematic review and meta-analysis. Front Immunol 2022; 13:952802. [PMID: 36275665 PMCID: PMC9581295 DOI: 10.3389/fimmu.2022.952802] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAn increasing number of studies have validated the prognostic significance of the controlling nutritional status (CONUT) score in patients with solid tumors. However, the extent of the correlation between the CONUT score and clinical outcomes of patients with hematologic malignancies is unclear.ObjectiveThis study aimed to investigate the prognostic role of the CONUT score in patients with hematologic malignancies.MethodsAll relevant articles published up to November 15, 2021, were identified by systematically searching PubMed, Embase, Web of Science, and Cochrane Library. Pooled hazard ratios (HRs) and 95% confidence intervals were used to quantitatively analyze the association between the CONUT scores and clinical outcomes of patients with hematologic malignancies. Subgroup and sensitivity analyses were performed. Funnel plots as well as Begg’s and Egger’s tests were used to assess publication bias.ResultsSix studies with 1811 patients were included in the meta-analysis. The results showed that a high CONUT score was associated with worse overall survival (OS) (HR=1.34, 95%CI 1.14-1.59, P < 0.001) and progression-free survival (PFS) (HR=1.20, 95%CI 1.10-1.32, P < 0.001).ConclusionsThe CONUT score is an independent prognostic factor in patients with hematologic malignancies.Systematic review registrationhttp://www.crd.york.ac.uk/prospero/, identifier CRD42021292621.
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Affiliation(s)
- Chuanyang Lu
- Department of Hematology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China
- Key Laboratory of Hematology, Nanjing Medical University, Nanjing, China
| | - Qiuni Chen
- Department of Hematology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China
- Key Laboratory of Hematology, Nanjing Medical University, Nanjing, China
| | - Linrong Fei
- Department of Hematology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China
- Key Laboratory of Hematology, Nanjing Medical University, Nanjing, China
| | - Junhui Wang
- The Huaian Clinical College of Xuzhou Medical University, Huaian, China
| | - Chunling Wang
- Department of Hematology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China
- Key Laboratory of Hematology, Nanjing Medical University, Nanjing, China
- *Correspondence: Chunling Wang, ; Liang Yu,
| | - Liang Yu
- Department of Hematology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, China
- Key Laboratory of Hematology, Nanjing Medical University, Nanjing, China
- *Correspondence: Chunling Wang, ; Liang Yu,
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3
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Akhtar OS, Huang LW, Tsang M, Torka P, Loh KP, Morrison VA, Cordoba R. Geriatric assessment in older adults with Non-Hodgkin lymphoma: A Young International Society of Geriatric Oncology (YSIOG) review paper. J Geriatr Oncol 2022; 13:572-581. [PMID: 35216939 DOI: 10.1016/j.jgo.2022.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/08/2022] [Indexed: 12/13/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a disease of older adults, with a median age at diagnosis of 67 years. Treatment in older adults with NHL is challenging. The aging process is associated with a decline in functional reserve that varies among individuals, and results in an increasing risk of treatment-related toxicity and mortality. Chronological age and performance status fail to capture the multidimensional and heterogeneous nature of the aging process. A geriatric assessment (GA) screens multiple geriatric domains and provides a more accurate assessment of functional reserve. Several abbreviated GA tools have been developed for use in oncology clinics and help identify patients at high risk for chemotherapy-related toxicity and mortality. In this review, we explore GA tools validated for use in patients with NHL. We discuss the evidence behind GA-guided treatment in NHL and present a suggested approach to assessing frailty in this patient population.
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Affiliation(s)
| | - Li-Wen Huang
- San Francisco VA Medical Center, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Mazie Tsang
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Kah Poh Loh
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY, USA
| | - Vicki A Morrison
- Hennepin Healthcare/University of Minnesota, Minneapolis, MN, USA
| | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
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4
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Chen HY, Zhang WL, Zhang L, Yang P, Li F, Yang ZR, Wang J, Pang M, Hong Y, Yan C, Li W, Liu J, Xu N, Chen L, Xiao XB, Qin Y, He XH, Liu H, Zhu HC, He C, Lin J, Jing HM. 5-Hydroxymethylcytosine profiles of cfDNA are highly predictive of R-CHOP treatment response in diffuse large B cell lymphoma patients. Clin Epigenetics 2021; 13:33. [PMID: 33573703 PMCID: PMC7879534 DOI: 10.1186/s13148-020-00973-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background Although R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) remains the standard chemotherapy regimen for diffuse large B cell lymphoma (DLBCL) patients, not all patients are responsive to the scheme, and there is no effective method to predict treatment response. Methods We utilized 5hmC-Seal to generate genome-wide 5hmC profiles in plasma cell-free DNA (cfDNA) from 86 DLBCL patients before they received R-CHOP chemotherapy. To investigate the correlation between 5hmC modifications and curative effectiveness, we separated patients into training (n = 56) and validation (n = 30) cohorts and developed a 5hmC-based logistic regression model from the training cohort to predict the treatment response in the validation cohort. Results In this study, we identified thirteen 5hmC markers associated with treatment response. The prediction performance of the logistic regression model, achieving 0.82 sensitivity and 0.75 specificity (AUC = 0.78), was superior to existing clinical indicators, such as LDH and stage. Conclusions Our findings suggest that the 5hmC modifications in cfDNA at the time before R-CHOP treatment are associated with treatment response and that 5hmC-Seal may potentially serve as a clinical-applicable, minimally invasive approach to predict R-CHOP treatment response for DLBCL patients.
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Affiliation(s)
- Hang-Yu Chen
- Synthetic and Functional Biomolecules Center, Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, Innovation Center for Genomics, Peking University, Beijing, 100871, People's Republic of China
| | - Wei-Long Zhang
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Lei Zhang
- Yang Sheng Tang Natural Medicine Research Institute, Hangzhou, 310024, People's Republic of China
| | - Ping Yang
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Fang Li
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Ze-Ruo Yang
- Yang Sheng Tang Natural Medicine Research Institute, Hangzhou, 310024, People's Republic of China
| | - Jing Wang
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Meng Pang
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Yun Hong
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Changjian Yan
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Wei Li
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Jia Liu
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Nuo Xu
- Synthetic and Functional Biomolecules Center, Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, Innovation Center for Genomics, Peking University, Beijing, 100871, People's Republic of China
| | - Long Chen
- Synthetic and Functional Biomolecules Center, Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, Innovation Center for Genomics, Peking University, Beijing, 100871, People's Republic of China
| | - Xiu-Bing Xiao
- Lymphoma Head and Neck Oncology, Fifth Medical Center of PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Yan Qin
- Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China
| | - Xiao-Hui He
- Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China
| | - Hui Liu
- Department of Hematology, Beijing Hospital, National Center of Gerontology, Beijing, 1000730, People's Republic of China
| | - Hai-Chuan Zhu
- Institute of Biology and Medicine, College of Life and Health 20 Sciences, Wuhan University of Science and Technology, Hubei, 430081, People's Republic of China
| | - Chuan He
- Department of Chemistry, University of Chicago, Chicago, IL, 60637, USA
| | - Jian Lin
- Synthetic and Functional Biomolecules Center, Beijing National Laboratory for Molecular Sciences, Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, College of Chemistry and Molecular Engineering, Innovation Center for Genomics, Peking University, Beijing, 100871, People's Republic of China.
| | - Hong-Mei Jing
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, 100191, People's Republic of China.
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5
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Jung J, Lee H, Heo JY, Chang MH, Lee E, Park WS, Park JH, Eom HS. High level of pre-treatment C-reactive protein to albumin ratio predicts inferior prognosis in diffuse large B-cell lymphoma. Sci Rep 2021; 11:2674. [PMID: 33514832 PMCID: PMC7846592 DOI: 10.1038/s41598-021-82087-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 01/05/2021] [Indexed: 11/09/2022] Open
Abstract
The C-reactive protein-to-albumin ratio (CAR) has not been assessed in diffuse large B cell lymphoma (DLBCL, the most common non-Hodgkin lymphoma). This retrospective study evaluated the prognostic value of CAR in 186 DLBCL patients. A CAR value of 0.158 was selected as the most discriminative cut-off for identifying patients with high CAR values (73/141 patients, 51.8%). During a median follow-up of 32.5 months, the high CAR group had significantly poorer complete response to induction therapy (64.4% vs. 92.6%; p < 0.001), 3-year overall survival (OS) (68.3% vs. 96.2%; p < 0.0001), and 3-year progression-free survival (PFS) (53.5% vs. 88.0%; p < 0.0001). After adjusting for the International Prognostic Index components, a high CAR value independently predicted poor OS (HR: 6.02, 95% CI 1.19-30.38; p = 0.030) and PFS (HR: 3.62, 95% CI 1.40-9.36; p = 0.008). In an independent validation cohort (n = 50), patients with CAR > 0.158 also showed worse 3-year OS (47.9% vs. 87.2%, p = 0.0035) and 3-year PFS (36.1% vs. 82.1%, p = 0.0011). A high CAR remained significantly associated with poor outcomes for > 60-year-old patients (OS: p = 0.0038, PFS: p = 0.0015) and younger patients (OS: p = 0.0041, PFS: p = 0.0044). Among older patients, a high CAR value also predicted non-relapse mortality (p = 0.035). Therefore, the CAR might complement the International Prognostic Index in DLBCL cases.
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Affiliation(s)
- Jongheon Jung
- Center for Hematologic Malignancy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Geyonggi, 410-769, Republic of Korea
| | - Hyewon Lee
- Center for Hematologic Malignancy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Geyonggi, 410-769, Republic of Korea.,Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ja Yoon Heo
- Division of Oncology-HematologyDepartment of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
| | - Myung Hee Chang
- Division of Oncology-HematologyDepartment of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
| | - Eunyoung Lee
- Center for Hematologic Malignancy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Geyonggi, 410-769, Republic of Korea
| | - Weon Seo Park
- Department of Pathology, National Cancer Center, Goyang, Republic of Korea
| | - Ju-Hyun Park
- Department of Statistics, Dongguk University, Seoul, Republic of Korea
| | - Hyeon-Seok Eom
- Center for Hematologic Malignancy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Geyonggi, 410-769, Republic of Korea.
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6
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Hohloch K, Ziepert M, Truemper L, Buske C, Held G, Poeschel V, Chapuy B, Altmann B. Low serum albumin is an independent risk factor in elderly patients with aggressive B‐cell lymphoma: Results from prospective trials of the German High‐Grade Non‐Hodgkin's Lymphoma Study Group. ACTA ACUST UNITED AC 2020; 1:181-187. [PMID: 35847697 PMCID: PMC9175786 DOI: 10.1002/jha2.61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/18/2022]
Abstract
Serum albumin a well‐known risk factor predicting outcome in many solid tumors. We explore the role of low serum albumin (≤3.5 g/dL) as an independent risk factor in elderly patients with aggressive B‐cell lymphoma. Outcome of 429 patients treated with R‐CHOP‐14 in the RICOVER‐60 trial and available serum albumin were analyzed in this retrospective study. Of the 429 patients in the RICOVER‐60 trial, 137 (32%) had low and 292 (68%) had normal serum albumin levels (>3.5 g/dL). In the low albumin group, patients had significantly higher International Prognostic Index (IPI), bulky disease, extralymphatic involvement, and B‐symptoms. Event‐free survival (EFS) (P < .001), progression‐free survival (PFS) (P < .001), and overall survival (OS) (P < .001) were significantly inferior for patients with low compared to those with normal serum albumin. Multivariate analysis adjusted for IPI shows following Hazard ratios (HR) for low serum albumin: EFS (HR = 1.5; 95% confidance interval [CI] [1.1; 2.1], P = .009), PFS (HR = 1.7; 95% CI [1.2; 2.4], P = .001) and OS (HR = 1.6; 95% CI [1.1; 2.3], P = .006). Results were confirmed in 185 patients from the DENSE‐R‐CHOP‐14 and SMARTE‐R‐CHOP‐14 trials. In conclusion, low serum albumin is an independent risk factor in elderly patients with aggressive B‐cell lymphoma treated with R‐CHOP.
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Affiliation(s)
- Karin Hohloch
- Department of Hematology and OncologyKantonsspital Graubünden Chur Switzerland
- Department of Hematology and OncologyUniversity Medical CenterGeorg‐August University Göttingen Germany
| | - Marita Ziepert
- Statistics and EpidemiologyInstitute for Medical InformaticsUniversity of Leipzig Leipzig Germany
| | - Lorenz Truemper
- Department of Hematology and OncologyUniversity Medical CenterGeorg‐August University Göttingen Germany
| | - Christian Buske
- Comprehensive Cancer Center UlmInstitute of Experimental Cancer ResearchUniversity Hospital Ulm Ulm Germany
| | - Gerhard Held
- Department of Internal MedicineUniversity Hospital Saarland Homburg Germany
| | - Viola Poeschel
- Department of Internal MedicineUniversity Hospital Saarland Homburg Germany
| | - Bjoern Chapuy
- Department of Hematology and OncologyUniversity Medical CenterGeorg‐August University Göttingen Germany
| | - Bettina Altmann
- Statistics and EpidemiologyInstitute for Medical InformaticsUniversity of Leipzig Leipzig Germany
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7
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Zhu J, Yang Y, Tao J, Wang SL, Chen B, Dai JR, Hu C, Qi SN, Li YX. Association of progression-free or event-free survival with overall survival in diffuse large B-cell lymphoma after immunochemotherapy: a systematic review. Leukemia 2020; 34:2576-2591. [PMID: 32651542 PMCID: PMC7515849 DOI: 10.1038/s41375-020-0963-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/01/2020] [Indexed: 12/18/2022]
Abstract
To investigate progression-free survival (PFS) and event-free survival (EFS) as early efficacy endpoints in diffuse large B-cell lymphoma (DLBCL), this systematic review included phase III randomized controlled trials (RCTs), phase II trials, and retrospective studies in newly diagnosed DLBCL receiving rituximab-containing chemotherapy through databases search up to 2019. Quality control was performed, where studies with high risk of bias were excluded. Prediction models were first established using the RCTs, and then externally validated in the phase II and retrospective populations. Trial-level surrogacy analysis was conducted by correlating the logarithmic (log) hazard ratio (HR) for PFS or EFS and log HR for OS. Correlation analysis at treatment arm-level was performed between 1-, 2-, 3-, and 5-year PFS or EFS rates and 5-year OS. The correlation was evaluated using the Pearson correlation coefficient r in weighted linear regression, with weight equal to patient size. Sensitivity analyses were performed to assess the consistency of predictive model by leaving one subgroup of trials out at a time. Twenty-six phase III RCTs, 4 phase II trials and 47 retrospective studies were included. In trial-level surrogacy, PFS (r, 0.772; 95% confidence interval [CI], 0.471-0.913) or EFS (r, 0.838; 95% CI, 0.625-0.938) were associated with OS. For rituximab immunochemotherapy treatment arms in RCTs, there was a linear correlation between 1 and 5-year PFS (r, 0.813-0.873) or EFS (r, 0.853-0.931) and 5-year OS. Sensitivity analysis demonstrated reasonable overall consistency. The correlation between PFS and OS was externally validated using independent phase II, and retrospective data (r, 0.795-0.897). We recommend PFS and EFS as earlier efficacy endpoints in patients with DLBCL primarily treated with rituximab-containing immunochemotherapy.
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Affiliation(s)
- Jie Zhu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Collaborative Innovation Center for Cancer Medicine, Beijing, P.R. China.,Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, P.R. China
| | - Yong Yang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Collaborative Innovation Center for Cancer Medicine, Beijing, P.R. China
| | - Jin Tao
- Institute of Basic Medical Sciences, Department of Human Anatomy, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, P.R. China
| | - Shu-Lian Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Collaborative Innovation Center for Cancer Medicine, Beijing, P.R. China
| | - Bo Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Collaborative Innovation Center for Cancer Medicine, Beijing, P.R. China
| | - Jian-Rong Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Collaborative Innovation Center for Cancer Medicine, Beijing, P.R. China
| | - Chen Hu
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Shu-Nan Qi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Collaborative Innovation Center for Cancer Medicine, Beijing, P.R. China.
| | - Ye-Xiong Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Collaborative Innovation Center for Cancer Medicine, Beijing, P.R. China.
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8
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Jelicic J, Larsen TS, Frederiksen H, Andjelic B, Maksimovic M, Bukumiric Z. Statistical Challenges in Development of Prognostic Models in Diffuse Large B-Cell Lymphoma: Comparison Between Existing Models - A Systematic Review. Clin Epidemiol 2020; 12:537-555. [PMID: 32581596 PMCID: PMC7266947 DOI: 10.2147/clep.s244294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background and Aim Based on advances in the diagnosis, classification, and management of diffuse large B-cell lymphoma (DLBCL), a number of new prognostic models have been proposed. The aim of this study was to review and compare different prognostic models of DLBCL based on the statistical methods used to evaluate the performance of each model, as well as to analyze the possible limitations of the methods. Methods and Results A literature search identified 46 articles that proposed 55 different prognostic models for DLBCL by combining different clinical, laboratory, and other parameters of prognostic significance. In addition, six studies used nomograms, which avoid risk categorization, to create prognostic models. Only a minority of studies assessed discrimination and/or calibration to compare existing models built upon different statistical methods in the process of development of a new prognostic model. All models based on nomograms reported the c-index as a measure of discrimination. There was no uniform evaluation of the performance in other prognostic models. We compared these models of DLBCL by calculating differences and ratios of 3-year overall survival probabilities between the high- and the low-risk groups. We found that the highest and lowest ratio between low- and high-risk groups was 6 and 1.31, respectively, while the difference between these groups was 18.9% and 100%, respectively. However, these studies had limited duration of follow-up and the number of patients ranged from 71 to 335. Conclusion There is no universal statistical instrument that could facilitate a comparison of prognostic models in DLBCL. However, when developing a prognostic model, it is recommended to report its discrimination and calibration in order to facilitate comparisons between different models. Furthermore, prognostic models based on nomograms are becoming more appealing owing to individualized disease-related risk estimations. However, they have not been validated yet in other study populations.
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Affiliation(s)
- Jelena Jelicic
- Department of Hematology, Odense University Hospital, Odense, Denmark
| | - Thomas Stauffer Larsen
- Department of Hematology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Henrik Frederiksen
- Department of Hematology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bosko Andjelic
- Department of Haematology, Blackpool Victoria Hospital, Lancashire Haematology Centre, Blackpool, UK
| | - Milos Maksimovic
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - Zoran Bukumiric
- Department of Statistics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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9
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Di QS, Xu T, Song Y, Zuo ZG, Cao FJ, Yu XJ, Tang JY, Zhang W, Li C, Wan GX, Cai XJ. High C-Reactive Protein to Albumin Ratio Predicts Inferior Clinical Outcomes in Extranodal Natural Killer T-Cell Lymphoma. Dose Response 2020; 18:1559325820917824. [PMID: 32284703 PMCID: PMC7139182 DOI: 10.1177/1559325820917824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/26/2020] [Accepted: 03/11/2020] [Indexed: 11/16/2022] Open
Abstract
Objective: The prognostic value of C-reactive protein to albumin ratio (CAR) has been
identified in several cancers but not in extranodal natural killer T-cell
lymphoma (ENKTL) as yet. We aimed to evaluate the prognostic value of CAR in
ENKTL. Methods: A retrospective study with 246 patients with ENKTL was performed to determine
the prognostic value of pretreatment CAR and examine the prognostic
performance of CAR incorporating with International Prognostic Index (IPI)
or natural killer/T-cell lymphoma prognostic index (NKPI) by nomogram. Results: The Cox regression analyses showed that high CAR (>0.3) independently
predicted unfavorable progression-free survival (PFS, P =
.011) and overall survival (OS, P = .012). In the
stratification analysis, the CAR was able to separate patients into
different prognoses regarding both OS and PFS in Ann Arbor stage I+II as
well as III+IV, IPI score 0 to 1, and NKPI score 1 to 2 subgroups (all
P < .05). Additionally, the predictive accuracy of
the IPI-based nomogram incorporating CAR, albumin to globulin ratio (AGR),
and IPI for OS and PFS appeared to be lower than the NKPI-based nomogram
incorporating CAR, age, AGR, extranodal site, and NKPI. Conclusion: Pretreatment CAR is a simple and easily accessible parameter for
independently predicting OS and PFS in patients with ENKTL.
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Affiliation(s)
- Quan-Shu Di
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Tao Xu
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Ying Song
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Zhi-Gang Zuo
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Feng-Jun Cao
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Xiong-Jie Yu
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Ji-Ying Tang
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Wei Zhang
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Chen Li
- Laboratory of Medicinal Plant, Institute of Basic Medical Sciences, School of Basic Medicine, Hubei University of Medicine, Shiyan, Hubei, China.,Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Biomedical Research Institute, Hubei University of Medicine, Shiyan, Hubei, China
| | - Guo-Xing Wan
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Xiao-Jun Cai
- Department of Oncology, Renmin Hospital, Hubei, China
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10
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Wei Y, Wei X, Huang W, Song J, Zheng J, Zeng H, Liu J, Zhan M, Wei Q, Feng R. Albumin improves stratification in the low IPI risk patients with diffuse large B-cell lymphoma. Int J Hematol 2020; 111:681-685. [DOI: 10.1007/s12185-020-02818-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 12/28/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022]
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11
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Wang N, Desai A, Ge B, Li W, Jin X, Bai H, Yu K, Ye H. Prognostic value of hypoalbuminemia at diagnosis in de novo non-M3 acute myeloid leukemia. Leuk Lymphoma 2019; 61:641-649. [PMID: 31722601 DOI: 10.1080/10428194.2019.1686499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The association between serum albumin level and clinical outcomes has been reported for several hematological malignancies. Our study aimed to identify the relationship between serum albumin level at the time of diagnosis and subsequent clinical outcomes in patients with newly diagnosed acute myeloid leukemias (AMLs) other than acute promyelocytic leukemias (APLs). A total of 243 patients with de novo non-M3 AML were enrolled in this study. Variables including gender, age, serum albumin, white blood cell (WBC) count, hemoglobin (Hb), platelet (PLT) count, blasts at peripheral blood (PB) and bone marrow (BM), immunophenotype and cytogenetics at diagnosis, BM response after one course of chemotherapy and hematopoietic stem cell transplantation (HSCT) treatment were studied. We found that normal albumin level (serum albumin >3.5 g/dL) was significantly associated with superior overall survival (HR = 0.375, p < .001) and leukemia-free survival (HR = 0.411, p < .001). These results demonstrate that albumin could serve as a simple, cheap, and objective prognostication factor in refinement of AML regimens.
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Affiliation(s)
- Na Wang
- Health Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Aakash Desai
- Department of Medicine, University of Connecticut, Farmington, CT, USA
| | - Bei Ge
- Department of Infection Control, The Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenya Li
- Wenzhou Medical University, Wenzhou, China
| | - Xianghong Jin
- Wenzhou Medical University, Wenzhou, China.,Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | | | - Kang Yu
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Haige Ye
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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