Journal article
Personalized risk prediction for event-free survival at 24 months in patients with diffuse large B-cell lymphoma
American journal of hematology, Vol.91(2), pp.179-184
02/2016
DOI: 10.1002/ajh.24223
PMCID: PMC4801345
PMID: 26492520
Abstract
We recently defined event-free survival at 24 months (EFS24) as a clinically relevant outcome for patients with DLBCL. Patients who fail EFS24 have very poor overall survival, while those who achieve EFS24 have a subsequent overall survival equivalent to that of the age- and sex-matched general population. Here, we develop and validate a clinical risk calculator (IPI24) for EFS24. Model building was performed on a discovery dataset of 1,348 patients with DLBCL and treated with anthracycline-based immunochemotherapy. A multivariable model containing age, Ann Arbor stage, normalized serum LDH, ALC, ECOG performance status, bulky disease, and sex was identified. The model was then applied to an independent validation dataset of 1,177 DLBCL patients. The IPI24 score estimates the probability of failing to achieve the EFS24 endpoint for an individual patient. The IPI24 model showed superior discriminatory ability (c-statistic = 0.671) in the validation dataset compared to the IPI (c-statistic = 0.649) or the NCCN-IPI (c-statistic = 0.657). After recalibration of the model on the combined dataset, the median predicted probability of failing to achieve EFS24 was 36% (range, 12-88%), and the IPI24 showed an EFS24 gradient in all IPI groups. The IPI24 also identified a significant percentage of patients with high risk disease, with over 20% of patients having a 50% or higher risk of failing to achieve EFS24. The IPI24 provides an individual patient level probability of achieving the clinically relevant EFS24 endpoint. It can be used via electronic apps.
Details
- Title: Subtitle
- Personalized risk prediction for event-free survival at 24 months in patients with diffuse large B-cell lymphoma
- Creators
- Matthew J Maurer - Department of Health Sciences Research, Mayo Clinic, Rochester, MinnesotaJean-Philippe Jais - Department of Biostatistics, Necker Hospital, INSERM UMRS 872, AP-HP, Paris, FranceHervé Ghesquières - Centre National De La Recherche Scientifique (CNRS), Unite Mixte De Recherche (UMR), Université Claude Bernard, Lyon, FranceThomas E Witzig - Division of Hematology, Mayo Clinic, Rochester, MinnesotaFangxin Hong - Department of Biostatistics & Computational Biology, Harvard T.H. Chan, Boston, MassachusettsCorinne Haioun - Lymphoid Malignancies Unit, Henri Mondor Hospital, Université Paris-Est, Créteil, FranceCarrie A Thompson - Division of Hematology, Mayo Clinic, Rochester, MinnesotaCatherine Thieblemont - Hematology, APHP, Hôpital Saint Louis, INSERM U728, IUH, Paris, FranceIvana N Micallef - Division of Hematology, Mayo Clinic, Rochester, MinnesotaLuis F Porrata - Division of Hematology, Mayo Clinic, Rochester, MinnesotaVincent Ribrag - Department of Medical Oncology, Institut Gustave Roussy, Villejuif, FranceGregorz S Nowakowski - Division of Hematology, Mayo Clinic, Rochester, MinnesotaOlivier Casasnovas - Hopital Le Bocage, Dijon, FranceSerge Bologna - Department of Hematology, Centre Hospitalier Nancy-Brabois, Vandoeuvre, FranceFranck Morschhauser - Department of Hematology, Centre Hospitalier Régional Universitaire De Lille, Lille, FranceVicki A Morrison - Veterans Affairs Medical Center, Minneapolis, MinnesotaBruce A Peterson - Department of Medicine, University of Minnesota, Minneapolis, MinnesotaWilliam R Macon - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MinnesotaChristiane Copie-Bergman - INSERM Unité U955 Équipe 9, Créteil, FranceAndrew L Feldman - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MinnesotaSergei I Syrbu - Department of Pathology, University of Iowa College of Medicine, Iowa City, IowaPaul J Kurtin - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MinnesotaRandy D Gascoyne - Centre for Lymphoid Cancers, British Columbia Cancer Agency, Vancouver, British Columbia, CanadaHailun Li - Department of Biostatistics & Computational Biology, Harvard T.H. Chan, Boston, MassachusettsCristine Allmer - Department of Health Sciences Research, Mayo Clinic, Rochester, MinnesotaBrad S Kahl - Department of Medicine, Washington University, St. Louis, MissouriStephen M Ansell - Division of Hematology, Mayo Clinic, Rochester, MinnesotaSusan L Slager - Department of Health Sciences Research, Mayo Clinic, Rochester, MinnesotaBrian K Link - Department of Pathology, University of Iowa College of Medicine, Iowa City, IowaGilles Salles - Department of Hematology, Hospices Civils De Lyon, Pierre Benite, FranceThomas M Habermann - Division of Hematology, Mayo Clinic, Rochester, MinnesotaHervé Tilly - Department of Hematology, INSERM U918, IRIB, Centre Henri Becquerel, Rouen, FranceJames R Cerhan - Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
- Resource Type
- Journal article
- Publication Details
- American journal of hematology, Vol.91(2), pp.179-184
- Publisher
- United States
- DOI
- 10.1002/ajh.24223
- PMID
- 26492520
- PMCID
- PMC4801345
- ISSN
- 0361-8609
- eISSN
- 1096-8652
- Grant note
- P30 CA015083 / NCI NIH HHS P50 CA097274 / NCI NIH HHS
- Language
- English
- Date published
- 02/2016
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Pathology; Internal Medicine
- Record Identifier
- 9984046924902771
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