|Table of Contents|

Risk factors related to the death of patients with diffuse large B-cell lymphoma within one year and the construction of prediction model

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2025 02
Page:
263-268
Research Field:
Publishing date:

Info

Title:
Risk factors related to the death of patients with diffuse large B-cell lymphoma within one year and the construction of prediction model
Author(s):
LI Nana1; DING Binbin1; DONG Bai1; LI Zijian2
1.The First School of Clinical Medicine,Lanzhou University，Gansu Lanzhou 730000,China；2.Department of Hematology,the First Hospital of Lanzhou University,Gansu Lanzhou 730000,China.
Keywords:
diffuse large B-cell lymphoma; risk of death; risk factors; predictive model
PACS:
R733
DOI:
10.3969/j.issn.1672-4992.2025.02.014
Abstract:
Objective:To investigate the risk factors related to death with 1 year in diffuse large B-cell lymphoma(DLBCL) and construct a prediction model based on the minimum absolute shrinkage and selection algorithm(LASSO) regression.Methods:Collecting the clinical data of patients with confirmed diffuse large B-cell lymphoma treated in the First Hospital of Lanzhou University from January 2013 to June 2024.The patients were divided into death and survival groups according to whether death within 1 year.Comparing the clinical data of the patients and analyzing the related risk factors for their death.Screating variables based on minimum absolute shrinkage and selection algorithm,to obtain independent predictors of death within 1 year in diffuse large B-cell lymphoma patients with a characteristic variable as an independent variable,and to construct a prediction model.The ROC curve,calibration curve,and clinical decision curve analysis(DCA) were drawn to evaluate the prediction effect of the model.Results:LASSO regression selected the four characteristic variables with the most generalization ability:Ki67,ECOG score,6 cycles of chemotherapy completed,and IPI score.The corresponding LASSO regression coefficients were 0.506，0.483，-0.855 and 2.595,respectively.After adjustment and correction for the multivariate Logistic regression analysis,Ki67,ECOG score,6 cycles of chemotherapy,IPI score were independent predictors of death within 1 year in patients with diffuse large B-cell lymphoma(P＜0.05).Building the nomogram,the ROC curve of the nomogram model showed that the area under the ROC curve(AUC) was 0.944(95%CI:0.906 to 0.983).The calibration curve showed the Hosmer-Lemeshow goodness of fit test(χ2=9.185 6,df=7,P=0.239 6).The DCA curve showed that the model had a clear positive net gain.Conclusion:Ki67,ECOG score,6 cycles of chemotherapy completed,and IPI score are independent predictors of death within 1 year in patients with diffuse large B-cell lymphoma.The clinical prediction model constructed with these variables can better predict the prognosis of diffuse large B-cell lymphoma and identify people at risk of death.

References:

［1］ALYAMANY R,EI FAKIH R,AlNUGHMUSH A,et al.A comprehensive review of the role of bone marrow biopsy and PET-CT in the evaluation of bone marrow involvement in adults newly diagnosed with DLBCL［J］.Front Oncol,2024,14:1301979.
［2］WANG SS.Epidemiology and etiology of diffuse large B-cell lymphoma［J］.Semin Hematol,2023,60(5):255-266.
［3］WANG P,CHEN K,WANG J,et al.A new nomogram for assessing complete response(CR) in gastric diffuse large B-cell lymphoma(DLBCL) patients after chemotherapy［J］.J Cancer Res Clin Oncol,2023,149(12):9757-9765.
［4］SHI H,PAN Y,XIANG G,et al.A novel NET-related gene signature for predicting DLBCL prognosis［J］.J Transl Med,2023,21(1):630.
［5］MU K,ZHANG J,GU Y,et al.Development and validation of a nomogram for predicting cardiovascular mortality risk for diffuse large B-cell lymphoma in children,adolescents,and adults［J］.Front Pediatr,2024,12:1346006.
［6］WANG J,PENG H,ZHANG G,et al.Identification of a novel model based on ferroptosis-related genes for predicting the prognosis of diffuse large B-cell lymphomas［J］.Hematology,2023,28(1):2198862.
［7］刘鹏,姜时雨,何小慧,等.老年弥漫大B细胞淋巴瘤患者一线治疗方案疗效比较和预后分析［J］.中华肿瘤杂志,2020,42(03):234-241. LIU P,JIANG SY,HE XH,et al.Comparison and outcome analysis of first-line treatment regimen in elderly patients with diffuse large B cell lymphoma ［J］.Chinese Journal of Oncology,2020,42(03):234-241.
［8］王美佳,刘虹伶,杨利华,等.R-CHOP治疗老年弥漫性大B细胞淋巴瘤患者疗效及其预后相关影响因素分析［J］.老年医学与保健,2024,30(03):655-661. WANG MJ,LIU HL,YANG LH,et al.Analysis of the efficacy of R-CHOP in R elderly patients with diffuse large B-cell lymphoma ［J］.Geriatric atrics and Health Care,2024,30(03):655-661.
［9］刘真真,殷莉.影响弥漫性大B细胞淋巴瘤患者预后相关因素分析［J］.临床研究,2023,31(11):1-4. LIU ZZ,YIN L.Analysis of prognosis-related factors affecting patients with diffuse large B-cell lymphoma ［J］.Clinical Studies,2023,31(11):1-4.
［10］段洋洋,寇俊平,罗璐.利妥昔单抗联合来那度胺维持治疗老年弥漫大B细胞淋巴瘤的临床效果［J］.河南医学研究,2024,33(03):529-532. DUAN YY,KOU JP,LUO L.Clinical effect of rituximab combined with lenalidomide maintenance in the treatment of elderly diffuse large B cell lymphoma ［J］.Henan Medical Research,2024,33(03):529-532.
［11］ZHANG L,JING H,TANG S,et al.Benefits of dynamic nomogram models for elderly diffuse large B-cell lymphoma patients' early death prediction and clinical application［J］.Mediators Inflamm,2023,2023:7874239.
［12］CHO SF,LIU YC,HSIAO HH,et al.Investigation on treatment strategy,prognostic factors,and risk factors for early death in elderly Taiwanese patients with diffuse large B-cell lymphoma［J］.Sci Rep,2017,7:44282.
［13］WAN M,ZHANG W,HUANG H,et al.Development and validation of a novel prognostic nomogram for advanced diffuse large B cell lymphoma［J］.Clin Exp Med,2024,24(1):64.
［14］FAN X,ZANG L,ZHAO BB,et al.Development and validation of prognostic scoring in primary intestinal diffuse large B-cell lymphoma:A single-institution study of 184 patients［J］.Ann Transl Med,2021,9(20):1542.
［15］FAN S,ZHAO Z,YU H,et al.Applying probability calibration to ensemble methods to predict 2-year mortality in patients with DLBCL［J］.BMC Med Inform Decis Mak,2021,21(1):14.
［16］FABBRI N,MUSSETTI A,SUREDA A.Second-line treatment of diffuse large B-cell lymphoma:Evolution of options［J］.Semin Hematol,2023,60(5):305-312.
［17］VODICKA P,KLENER P,TRNENY M.Diffuse large B-cell lymphoma(DLBCL):Early patient management and emerging treatment options［J］.Onco Targets Ther,2022,15:1481-1501.
［18］李希希，秦玲.胃肠道弥漫大B细胞淋巴瘤的治疗及相关潜在预后因素的研究进展［J］.现代肿瘤医学，2023,31（3）：580-584. LI XX,QIN L.Advances in treatment of gastrointestinal diffuse large B-cell lymphoma and related potential prognostic factors［J］.Modern Oncology，2023,31（3）：580-584.
［19］XU H,YAN R,YE C,et al.Specific mortality in patients with diffuse large B-cell lymphoma:A retrospective analysis based on the surveillance,epidemiology,and end results database［J］.Eur J Med Res,2024,29(1):241.
［20］TAVAKKOLI M,BARTA SK.2024 update:Advances in the risk stratification and management of large B-cell lymphoma［J］.Am J Hematol,2023,98(11):1791-1805.

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