KEY TAKEAWAYS
- The study aimed to identify independent prognostic markers to enhance risk stratification in AR-DLBCL.
- The results demonstrated the Hb/RDW ratio as an independent predictor in AR-DLBCL, partially enhancing prognostic accuracy when integrated into the IPI score.
Despite the advent of combined antiretroviral therapy, AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) remains prevalent among HIV-positive individuals with a suboptimal prognosis. Enhancing risk stratification through independent prognostic marker identification is crucial.
Juanjuan Chen and the team conducted a study that aimed to enhance risk stratification in AR-DLBCL by identifying independent prognostic markers.
This retrospective multicenter cohort study, conducted from 2011 to 2019, included 153 eligible AR-DLBCL patients. Overall survival factors were assessed using Kaplan-Meier curves and Cox proportional hazards models (univariate and multivariate). The discriminatory capability of the risk score was determined using the area under the receiver operating characteristic curve.
The cohort included 153 patients, with a median age of 47 years (IQR 39-58), predominantly male (83.7%). Median follow-up was 12.0 months (95% CI 8.5-15.5), showing a 35.9% overall survival (OS) rate. Among inflammatory markers, only the Hb/RDW ratio emerged as an independent prognostic factor for OS in both training (HR = 2.645, 95% CI = 1.267-5.522, P = 0.010) and validation cohorts (HR = 2.645, 95% CI = 1.267-5.522, P = 0.010).
A reduced Hb/RDW ratio showed significant correlation with adverse clinical factors: advanced Ann Arbor stage, increased extranodal sites, lower CD4 count, elevated lactate dehydrogenase levels, poorer Eastern Cooperative Oncology Group performance status (ECOG PS), and higher International Prognostic Index (IPI) score. Incorporating the Hb/RDW ratio into the IPI led to the creation of a highly discriminatory composite score, termed Hb/RDW-IPI.
The study concluded that the Hb/RDW ratio, an easily accessible and cost-effective inflammatory biomarker, serves as an independent predictor of outcomes in AR-DLBCL patients. Integrating it into the IPI score enhances prognostic accuracy. Funding was received from the GuangDong Basic and Applied Basic Research Foundation.
Source: https://pubmed.ncbi.nlm.nih.gov/38426083/
Chen J, Wu Y, Zhao H, et al. (2024). “Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL.” Front Immunol. 2024 Feb 15;15:1354325. doi: 10.3389/fimmu.2024.1354325. PMID: 38426083; PMCID: PMC10901994.
