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

Stefan K. Barta, Xiaonan (Nan) Xue, Dan Wang, Jeannette Y. Lee, Lawrence D. Kaplan, Josep Maria Ribera, Albert Oriol, Michele Spina, Umberto Tirelli, Francois Boue, Wyndham H. Wilson, Christoph Wyen, Kieron Dunleavy, Ariela Noy, Joseph A. Sparano

Research output: Contribution to journalArticle

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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 (n=243) set. 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 AIDSrelated 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). Twenty-eight percent of patients were defined as low risk by the ARL-IPI and had an estimated 5-year overall survival (OS) of 78% (52% intermediate risk, 5-year OS 60%; 20% high risk, 5-year OS 50%).

Original languageEnglish (US)
Pages (from-to)1731-1737
Number of pages7
JournalHaematologica
Volume99
Issue number11
DOIs
StatePublished - Nov 1 2014

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AIDS-Related Lymphoma
Survival
Rituximab
HIV
B-Cell Lymphoma
CD4 Lymphocyte Count
Viral Load
Non-Hodgkin's Lymphoma
HIV Infections
Lymphoma
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Hematology

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A new prognostic score for AIDS-related lymphomas in the rituximab-era. / Barta, Stefan K.; Xue, Xiaonan (Nan); Wang, Dan; Lee, Jeannette Y.; Kaplan, Lawrence D.; Ribera, Josep Maria; Oriol, Albert; Spina, Michele; Tirelli, Umberto; Boue, Francois; Wilson, Wyndham H.; Wyen, Christoph; Dunleavy, Kieron; Noy, Ariela; Sparano, Joseph A.

In: Haematologica, Vol. 99, No. 11, 01.11.2014, p. 1731-1737.

Research output: Contribution to journalArticle

Barta, SK, Xue, XN, Wang, D, Lee, JY, Kaplan, LD, Ribera, JM, Oriol, A, Spina, M, Tirelli, U, Boue, F, Wilson, WH, Wyen, C, Dunleavy, K, Noy, A & Sparano, JA 2014, 'A new prognostic score for AIDS-related lymphomas in the rituximab-era', Haematologica, vol. 99, no. 11, pp. 1731-1737. https://doi.org/10.3324/haematol.2014.111112
Barta, Stefan K. ; Xue, Xiaonan (Nan) ; Wang, Dan ; Lee, Jeannette Y. ; Kaplan, Lawrence D. ; Ribera, Josep Maria ; Oriol, Albert ; Spina, Michele ; Tirelli, Umberto ; Boue, Francois ; Wilson, Wyndham H. ; Wyen, Christoph ; Dunleavy, Kieron ; Noy, Ariela ; Sparano, Joseph A. / A new prognostic score for AIDS-related lymphomas in the rituximab-era. In: Haematologica. 2014 ; Vol. 99, No. 11. pp. 1731-1737.
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AU - Kaplan, Lawrence D.

AU - Ribera, Josep Maria

AU - Oriol, Albert

AU - Spina, Michele

AU - Tirelli, Umberto

AU - Boue, Francois

AU - Wilson, Wyndham H.

AU - Wyen, Christoph

AU - Dunleavy, Kieron

AU - Noy, Ariela

AU - Sparano, Joseph A.

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