Haematologica. 2014 Aug 22. pii: haematol.2014.111112.

A new prognostic score for AIDS-related lymphomas in the Rituximab-era.

Barta SK1, Xue X2, Wang D2, Lee JY3, Kaplan LD4, Ribera JM5, Oriol A5, Spina M6, Tirelli U7, Boue F8, Wilson WH9, Wyen C10, Dunleavy K9, Noy A11, Sparano JA12.
Author information 1Fox Chase Cancer Center, USA; stefan.barta@fccc.edu.2Albert-Einstein College of Medicine, USA;3University of Arkansas, USA;4University of California San Francisco, USA;5Hospital Universitari Germans Trias i Pujol, Spain;6National Cancer Institute;7National Cancer Institute, Italy;8Hopital Antoine Beclere, France;9National Cancer Institute, USA;10University Hospital Cologne, Germany;11Memorial-Sloan Kettering Cancer Center, USA;12Albert-Einstein Cancer Center, USA.

Abstract
While the International Prognostic Index is commonly used to predict outcomes in immunocompetent patients with aggressive B-cell Non-Hodgkin Lymphomas, HIV-infection is an important competing risk for death in patients with AIDS-related lymphomas. We investigated whether a newly created prognostic score (AIDS-related lymphoma International Prognostic Index) could better assess risk of death in patients with AIDS-related lymphomas. We randomly divided a dataset of 487 patients newly diagnosed with AIDS-related lymphomas and treated with rituximab-containing chemoimmunotherapy into a training (n=244) and validation set (n=243). We examined the association of HIV-related and other known risk factors with overall survival in both sets independently. We defined a new score (AIDS-related lymphoma International Prognostic Index) by assigning weights to each significant predictor (age-adjusted international prognostic index, extranodal sites, HIV-score [composed of CD4 count, viral load, and prior history of AIDS]) with three risk categories similar to the age-adjusted International Prognostic Index (low, intermediate and high risk). We compared the prognostic value for overall survival between AIDS-related lymphoma International Prognostic Index and age-adjusted International Prognostic Index in the validation set and found that the AIDS-related lymphoma International Prognostic Index performed significantly better in predicting risk of death than the age-adjusted International Prognostic Index (p=0.004) and better discriminated risk of death between each risk category (p=0.015 vs. p=0.13).


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