Prognostic impact of concordant and discordant bone marrow involvement on diffuse large B-cell lymphoma.

IF 1.5 4区医学 Q4 ONCOLOGY Translational cancer research Pub Date : 2024-10-31 Epub Date: 2024-10-24 DOI:10.21037/tcr-24-238

Huaqin Zuo, Xiaoyan Xie, Xing Sun, Hanxue Shi, Xiaoping Pei, Mei Sun

{"title":"Prognostic impact of concordant and discordant bone marrow involvement on diffuse large B-cell lymphoma.","authors":"Huaqin Zuo, Xiaoyan Xie, Xing Sun, Hanxue Shi, Xiaoping Pei, Mei Sun","doi":"10.21037/tcr-24-238","DOIUrl":null,"url":null,"abstract":"Background: In diffuse large B-cell lymphoma (DLBCL), bone marrow (BM) involvement includes two types that are concordant involvement and discordant involvement. It has been reported that concordant BM involvement has a worse prognosis than discordant involvement in previous studies. However, the prognostic effects of concordant or discordant BM involvement on DLBCL still need further research. In this work, DLBCL cases with BM involvement were collected and analyzed to better reflect the prognostic implications of concordant and discordant BM involvement.Methods: We reviewed the cases with newly diagnosed DLBCL and BM involvement from April 2018 to April 2022 in Northern Jiangsu People's Hospital. Overall survival (OS) and progression-free survival (PFS) were accessed by the Kaplan-Meier method and compared between groups by the log-rank test. A multivariate regression analysis based on Cox proportional hazard model was used to test the independent effect of each variable on survival.Results: In total, 32 patients were included and 15 (46.9%) patients had concordant BM involvement and 17 (53.1%) patients had discordant BM involvement. Compared with the discordant group, the concordant group tended to be older and had elevated lactate dehydrogenase level. The outcome of patients with concordant BM involvement was worse than the discordant subset, including OS (P=0.04) and PFS (P=0.03). Furthermore, the discordant BM involvement was excluded to acquire a BM-adjusted International Prognostic Index (IPI) score. The significance of BM-adjusted IPI scores to predict OS was improved greatly compared with the previous IPI scores (P=0.053 vs. P=0.16). Multivariate analysis showed that the BM-adjusted IPI was an independent predictor for OS [hazard ratio =3.406; 95% confidence interval (CI): 1.145-10.127; P=0.03].Conclusions: These results highlight the requirement for identifying BM infiltration type accurately and then adjusting the IPI score by excluding discordant BM involvement since concordant involvement can partly predict a poor prognosis of DLBCL with BM involvement other than discordant involvement.","PeriodicalId":23216,"journal":{"name":"Translational cancer research","volume":"13 10","pages":"5339-5346"},"PeriodicalIF":1.5000,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543059/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational cancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/tcr-24-238","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/24 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: In diffuse large B-cell lymphoma (DLBCL), bone marrow (BM) involvement includes two types that are concordant involvement and discordant involvement. It has been reported that concordant BM involvement has a worse prognosis than discordant involvement in previous studies. However, the prognostic effects of concordant or discordant BM involvement on DLBCL still need further research. In this work, DLBCL cases with BM involvement were collected and analyzed to better reflect the prognostic implications of concordant and discordant BM involvement.

Methods: We reviewed the cases with newly diagnosed DLBCL and BM involvement from April 2018 to April 2022 in Northern Jiangsu People's Hospital. Overall survival (OS) and progression-free survival (PFS) were accessed by the Kaplan-Meier method and compared between groups by the log-rank test. A multivariate regression analysis based on Cox proportional hazard model was used to test the independent effect of each variable on survival.

Results: In total, 32 patients were included and 15 (46.9%) patients had concordant BM involvement and 17 (53.1%) patients had discordant BM involvement. Compared with the discordant group, the concordant group tended to be older and had elevated lactate dehydrogenase level. The outcome of patients with concordant BM involvement was worse than the discordant subset, including OS (P=0.04) and PFS (P=0.03). Furthermore, the discordant BM involvement was excluded to acquire a BM-adjusted International Prognostic Index (IPI) score. The significance of BM-adjusted IPI scores to predict OS was improved greatly compared with the previous IPI scores (P=0.053 vs. P=0.16). Multivariate analysis showed that the BM-adjusted IPI was an independent predictor for OS [hazard ratio =3.406; 95% confidence interval (CI): 1.145-10.127; P=0.03].

Conclusions: These results highlight the requirement for identifying BM infiltration type accurately and then adjusting the IPI score by excluding discordant BM involvement since concordant involvement can partly predict a poor prognosis of DLBCL with BM involvement other than discordant involvement.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

骨髓受累对弥漫大 B 细胞淋巴瘤预后的影响。

背景：在弥漫大B细胞淋巴瘤（DLBCL）中，骨髓（BM）受累包括两种类型，即并发受累和不并发受累。据报道，在以往的研究中，并发骨髓受累比不并发受累的预后更差。然而，并发或不并发骨髓受累对 DLBCL 的预后影响仍需进一步研究。本研究收集并分析了有骨髓受累的DLBCL病例，以更好地反映并发和不并发骨髓受累对预后的影响：我们回顾了苏北人民医院2018年4月至2022年4月新诊断的DLBCL和BM受累病例。采用Kaplan-Meier法获取总生存期（OS）和无进展生存期（PFS），并通过log-rank检验进行组间比较。基于Cox比例危险模型的多变量回归分析用于检验各变量对生存期的独立影响：共纳入32例患者，其中15例（46.9%）为合并骨髓受累，17例（53.1%）为不合并骨髓受累。与不一致组相比，一致组患者年龄偏大，乳酸脱氢酶水平偏高。并发骨髓受累患者的预后比不并发亚组差，包括OS（P=0.04）和PFS（P=0.03）。此外，为了获得经骨髓调整的国际预后指数（IPI）评分，还排除了不一致的骨髓受累情况。与之前的IPI评分相比，BM调整后的IPI评分预测OS的意义大大提高（P=0.053 vs. P=0.16）。多变量分析显示，BM调整后的IPI是OS的独立预测因子[危险比=3.406；95%置信区间（CI）：1.145-10.127；P=0.03]：这些结果凸显了准确识别骨髓浸润类型的必要性，然后通过排除不一致的骨髓受累来调整IPI评分，因为一致的受累可部分预测不一致受累以外的骨髓受累的DLBCL的不良预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Translational cancer research ONCOLOGY-

CiteScore

2.10

自引率

0.00%

发文量

252

期刊介绍： Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.