Marginal zone lymphoma international prognostic index: a unifying prognostic index for marginal zone lymphomas requiring systemic treatment
Marginal zone lymphomas (MZL), comprised of three unique but related subtypes, lack a unifying prognostic score applicable to all the patients in need for systemic chemotherapy and/or immunotherapy. Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontli...
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| creator | Arcaini, Luca Bommier, Côme Alderuccio, Juan Pablo Merli, Michele Fabbri, Nicole Nizzoli, Maria Elena Maurer, Matthew J. Tarantino, Vittoria Ferrero, Simone Rattotti, Sara Talami, Annalisa Murru, Roberta Khurana, Arushi Mwangi, Raphael Deodato, Marina Cencini, Emanuele Re, Francesca Visco, Carlo Feldman, Andrew L. Link, Brian K. Delamain, Marcia Torresan Spina, Michele Annibali, Ombretta Pulsoni, Alessandro Ferreri, Andrés J.M. Stelitano, Caterina Cecilia Pennese, Elsa Habermann, Thomas M. Marcheselli, Luigi Han, Sunwoo Reis, Isildinha M. Paulli, Marco Lossos, Izidore S. Cerhan, James R. Luminari, Stefano |
| description | Marginal zone lymphomas (MZL), comprised of three unique but related subtypes, lack a unifying prognostic score applicable to all the patients in need for systemic chemotherapy and/or immunotherapy.
Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontline systemic therapy at diagnosis or after observation were used to train a prognostic model. The primary endpoint was progression-free survival (PFS) from start of treatment. The model was externally validated in a pooled analysis of two independent cohorts from the University of Iowa and Mayo Clinic Molecular Epidemiology Resource and the University of Miami.
We identified 501 eligible patients. After multivariable modeling, lactate dehydrogenase (LDH) above upper normal limit, hemoglobin |
| doi_str_mv | 10.1016/j.eclinm.2024.102592 |
| format | Article |
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Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontline systemic therapy at diagnosis or after observation were used to train a prognostic model. The primary endpoint was progression-free survival (PFS) from start of treatment. The model was externally validated in a pooled analysis of two independent cohorts from the University of Iowa and Mayo Clinic Molecular Epidemiology Resource and the University of Miami.
We identified 501 eligible patients. After multivariable modeling, lactate dehydrogenase (LDH) above upper normal limit, hemoglobin <12 g/dL, absolute lymphocyte count <1 × 109/L, platelets <100 × 109/L, and MZL subtype (nodal or disseminated) were independently associated with inferior PFS. The proposed MZL International Prognostic index (MZL-IPI) combined these 5 factors, and we defined low (LRG, 0 factors, 27%), intermediate (IRG, 1–2 factors, 57%) and high (HRG, 3+ factors, 16%) risk groups with 5-y PFS of 85%, 66%, and 37%, respectively (c-Harrell = 0.64). Compared to the LRG, the IRG (Hazard Ratio [HR] = 2.30, 95% CI 1.39–3.80) and HRG (HR = 5.41, 95% CI 3.12–9.38) had inferior PFS. Applying the MZL-IPI to the pooled US cohort (N = 353), 94 (27%), 192 (54%), and 67 (19%) patients were classified as LRG, IRG, and HRG, respectively, and the model was validated for PFS (log-rank test p = 0.0018; c-Harrell = 0.578, 95% CI 0.54–0.62). The MZL-IPI was also prognostic for OS in both the training and the external validation sets.
MZL-IPI is a new prognostic score for use in all patients with MZL considered for systemic treatment.
The MER was supported by P50 CA97274 and U01 CA195568.</description><identifier>ISSN: 2589-5370</identifier><identifier>EISSN: 2589-5370</identifier><identifier>DOI: 10.1016/j.eclinm.2024.102592</identifier><identifier>PMID: 38633575</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Marginal zone lymphoma ; Prognosis</subject><ispartof>EClinicalMedicine, 2024-06, Vol.72, p.102592, Article 102592</ispartof><rights>2024 The Author(s)</rights><rights>2024 The Author(s).</rights><rights>2024 The Author(s) 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c413t-a16c5acf63375dd7a09c76c4acba12625d56beb0cc3939dba8f150cc15aa1f9b3</cites><orcidid>0000-0002-0905-5927 ; 0000-0002-0432-9706 ; 0000-0002-9504-991X ; 0000-0001-8446-2285 ; 0000-0002-2690-3377</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11019091/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11019091/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38633575$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arcaini, Luca</creatorcontrib><creatorcontrib>Bommier, Côme</creatorcontrib><creatorcontrib>Alderuccio, Juan Pablo</creatorcontrib><creatorcontrib>Merli, Michele</creatorcontrib><creatorcontrib>Fabbri, Nicole</creatorcontrib><creatorcontrib>Nizzoli, Maria Elena</creatorcontrib><creatorcontrib>Maurer, Matthew J.</creatorcontrib><creatorcontrib>Tarantino, Vittoria</creatorcontrib><creatorcontrib>Ferrero, Simone</creatorcontrib><creatorcontrib>Rattotti, Sara</creatorcontrib><creatorcontrib>Talami, Annalisa</creatorcontrib><creatorcontrib>Murru, Roberta</creatorcontrib><creatorcontrib>Khurana, Arushi</creatorcontrib><creatorcontrib>Mwangi, Raphael</creatorcontrib><creatorcontrib>Deodato, Marina</creatorcontrib><creatorcontrib>Cencini, Emanuele</creatorcontrib><creatorcontrib>Re, Francesca</creatorcontrib><creatorcontrib>Visco, Carlo</creatorcontrib><creatorcontrib>Feldman, Andrew L.</creatorcontrib><creatorcontrib>Link, Brian K.</creatorcontrib><creatorcontrib>Delamain, Marcia Torresan</creatorcontrib><creatorcontrib>Spina, Michele</creatorcontrib><creatorcontrib>Annibali, Ombretta</creatorcontrib><creatorcontrib>Pulsoni, Alessandro</creatorcontrib><creatorcontrib>Ferreri, Andrés J.M.</creatorcontrib><creatorcontrib>Stelitano, Caterina Cecilia</creatorcontrib><creatorcontrib>Pennese, Elsa</creatorcontrib><creatorcontrib>Habermann, Thomas M.</creatorcontrib><creatorcontrib>Marcheselli, Luigi</creatorcontrib><creatorcontrib>Han, Sunwoo</creatorcontrib><creatorcontrib>Reis, Isildinha M.</creatorcontrib><creatorcontrib>Paulli, Marco</creatorcontrib><creatorcontrib>Lossos, Izidore S.</creatorcontrib><creatorcontrib>Cerhan, James R.</creatorcontrib><creatorcontrib>Luminari, Stefano</creatorcontrib><title>Marginal zone lymphoma international prognostic index: a unifying prognostic index for marginal zone lymphomas requiring systemic treatment</title><title>EClinicalMedicine</title><addtitle>EClinicalMedicine</addtitle><description>Marginal zone lymphomas (MZL), comprised of three unique but related subtypes, lack a unifying prognostic score applicable to all the patients in need for systemic chemotherapy and/or immunotherapy.
Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontline systemic therapy at diagnosis or after observation were used to train a prognostic model. The primary endpoint was progression-free survival (PFS) from start of treatment. The model was externally validated in a pooled analysis of two independent cohorts from the University of Iowa and Mayo Clinic Molecular Epidemiology Resource and the University of Miami.
We identified 501 eligible patients. After multivariable modeling, lactate dehydrogenase (LDH) above upper normal limit, hemoglobin <12 g/dL, absolute lymphocyte count <1 × 109/L, platelets <100 × 109/L, and MZL subtype (nodal or disseminated) were independently associated with inferior PFS. The proposed MZL International Prognostic index (MZL-IPI) combined these 5 factors, and we defined low (LRG, 0 factors, 27%), intermediate (IRG, 1–2 factors, 57%) and high (HRG, 3+ factors, 16%) risk groups with 5-y PFS of 85%, 66%, and 37%, respectively (c-Harrell = 0.64). Compared to the LRG, the IRG (Hazard Ratio [HR] = 2.30, 95% CI 1.39–3.80) and HRG (HR = 5.41, 95% CI 3.12–9.38) had inferior PFS. Applying the MZL-IPI to the pooled US cohort (N = 353), 94 (27%), 192 (54%), and 67 (19%) patients were classified as LRG, IRG, and HRG, respectively, and the model was validated for PFS (log-rank test p = 0.0018; c-Harrell = 0.578, 95% CI 0.54–0.62). The MZL-IPI was also prognostic for OS in both the training and the external validation sets.
MZL-IPI is a new prognostic score for use in all patients with MZL considered for systemic treatment.
The MER was supported by P50 CA97274 and U01 CA195568.</description><subject>Marginal zone lymphoma</subject><subject>Prognosis</subject><issn>2589-5370</issn><issn>2589-5370</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9UUtP3DAQtlBRQZR_UKEce9mtH3Gy5gBCqC-JigucrYkzWbxK7MV2ENu_0D9dR6EIVNST7fkeM56PkI-MLhll1efNEk1v3bDklJe5xKXie-SQy5VaSFHTdy_uB-Q4xg2llNNypSr6nhyIVSWErOUh-f0Twto66Itf3mHR74btnR-gsC5hcJCsn7Bt8GvnY7ImAy0-nhZQjM52O-vW_4BF50MxvGkbi4D3ow2TLO5iwiGLUkBIA7r0gex30Ec8fjqPyO3XLzeX3xdX199-XF5cLUzJRFoAq4wE0-Uv1LJta6DK1JUpwTTAeMVlK6sGG2qMUEK1Daw6JvOLSQDWqUYckfPZdzs2A7Ymtw7Q622weeqd9mD1a8TZO732D5rl3SuqWHb49OQQ_P2IMenBRoN9Dw79GLWgJeNCiGqiljPVBB9jwO65D6N6ylJv9JylnrLUc5ZZdvJyxmfR3-Qy4WwmYN7Ug8Wgo7HoDLY2oEm69fb_Hf4Axxq4Bw</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Arcaini, Luca</creator><creator>Bommier, Côme</creator><creator>Alderuccio, Juan Pablo</creator><creator>Merli, Michele</creator><creator>Fabbri, Nicole</creator><creator>Nizzoli, Maria Elena</creator><creator>Maurer, Matthew J.</creator><creator>Tarantino, Vittoria</creator><creator>Ferrero, Simone</creator><creator>Rattotti, Sara</creator><creator>Talami, Annalisa</creator><creator>Murru, Roberta</creator><creator>Khurana, Arushi</creator><creator>Mwangi, Raphael</creator><creator>Deodato, Marina</creator><creator>Cencini, Emanuele</creator><creator>Re, Francesca</creator><creator>Visco, Carlo</creator><creator>Feldman, Andrew L.</creator><creator>Link, Brian K.</creator><creator>Delamain, Marcia Torresan</creator><creator>Spina, Michele</creator><creator>Annibali, Ombretta</creator><creator>Pulsoni, Alessandro</creator><creator>Ferreri, Andrés J.M.</creator><creator>Stelitano, Caterina Cecilia</creator><creator>Pennese, Elsa</creator><creator>Habermann, Thomas M.</creator><creator>Marcheselli, Luigi</creator><creator>Han, Sunwoo</creator><creator>Reis, Isildinha M.</creator><creator>Paulli, Marco</creator><creator>Lossos, Izidore S.</creator><creator>Cerhan, James R.</creator><creator>Luminari, Stefano</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0905-5927</orcidid><orcidid>https://orcid.org/0000-0002-0432-9706</orcidid><orcidid>https://orcid.org/0000-0002-9504-991X</orcidid><orcidid>https://orcid.org/0000-0001-8446-2285</orcidid><orcidid>https://orcid.org/0000-0002-2690-3377</orcidid></search><sort><creationdate>20240601</creationdate><title>Marginal zone lymphoma international prognostic index: a unifying prognostic index for marginal zone lymphomas requiring systemic treatment</title><author>Arcaini, Luca ; Bommier, Côme ; Alderuccio, Juan Pablo ; Merli, Michele ; Fabbri, Nicole ; Nizzoli, Maria Elena ; Maurer, Matthew J. ; Tarantino, Vittoria ; Ferrero, Simone ; Rattotti, Sara ; Talami, Annalisa ; Murru, Roberta ; Khurana, Arushi ; Mwangi, Raphael ; Deodato, Marina ; Cencini, Emanuele ; Re, Francesca ; Visco, Carlo ; Feldman, Andrew L. ; Link, Brian K. ; Delamain, Marcia Torresan ; Spina, Michele ; Annibali, Ombretta ; Pulsoni, Alessandro ; Ferreri, Andrés J.M. ; Stelitano, Caterina Cecilia ; Pennese, Elsa ; Habermann, Thomas M. ; Marcheselli, Luigi ; Han, Sunwoo ; Reis, Isildinha M. ; Paulli, Marco ; Lossos, Izidore S. ; Cerhan, James R. ; Luminari, Stefano</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c413t-a16c5acf63375dd7a09c76c4acba12625d56beb0cc3939dba8f150cc15aa1f9b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Marginal zone lymphoma</topic><topic>Prognosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arcaini, Luca</creatorcontrib><creatorcontrib>Bommier, Côme</creatorcontrib><creatorcontrib>Alderuccio, Juan Pablo</creatorcontrib><creatorcontrib>Merli, Michele</creatorcontrib><creatorcontrib>Fabbri, Nicole</creatorcontrib><creatorcontrib>Nizzoli, Maria Elena</creatorcontrib><creatorcontrib>Maurer, Matthew J.</creatorcontrib><creatorcontrib>Tarantino, Vittoria</creatorcontrib><creatorcontrib>Ferrero, Simone</creatorcontrib><creatorcontrib>Rattotti, Sara</creatorcontrib><creatorcontrib>Talami, Annalisa</creatorcontrib><creatorcontrib>Murru, Roberta</creatorcontrib><creatorcontrib>Khurana, Arushi</creatorcontrib><creatorcontrib>Mwangi, Raphael</creatorcontrib><creatorcontrib>Deodato, Marina</creatorcontrib><creatorcontrib>Cencini, Emanuele</creatorcontrib><creatorcontrib>Re, Francesca</creatorcontrib><creatorcontrib>Visco, Carlo</creatorcontrib><creatorcontrib>Feldman, Andrew L.</creatorcontrib><creatorcontrib>Link, Brian K.</creatorcontrib><creatorcontrib>Delamain, Marcia Torresan</creatorcontrib><creatorcontrib>Spina, Michele</creatorcontrib><creatorcontrib>Annibali, Ombretta</creatorcontrib><creatorcontrib>Pulsoni, Alessandro</creatorcontrib><creatorcontrib>Ferreri, Andrés J.M.</creatorcontrib><creatorcontrib>Stelitano, Caterina Cecilia</creatorcontrib><creatorcontrib>Pennese, Elsa</creatorcontrib><creatorcontrib>Habermann, Thomas M.</creatorcontrib><creatorcontrib>Marcheselli, Luigi</creatorcontrib><creatorcontrib>Han, Sunwoo</creatorcontrib><creatorcontrib>Reis, Isildinha M.</creatorcontrib><creatorcontrib>Paulli, Marco</creatorcontrib><creatorcontrib>Lossos, Izidore S.</creatorcontrib><creatorcontrib>Cerhan, James R.</creatorcontrib><creatorcontrib>Luminari, Stefano</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>EClinicalMedicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arcaini, Luca</au><au>Bommier, Côme</au><au>Alderuccio, Juan Pablo</au><au>Merli, Michele</au><au>Fabbri, Nicole</au><au>Nizzoli, Maria Elena</au><au>Maurer, Matthew J.</au><au>Tarantino, Vittoria</au><au>Ferrero, Simone</au><au>Rattotti, Sara</au><au>Talami, Annalisa</au><au>Murru, Roberta</au><au>Khurana, Arushi</au><au>Mwangi, Raphael</au><au>Deodato, Marina</au><au>Cencini, Emanuele</au><au>Re, Francesca</au><au>Visco, Carlo</au><au>Feldman, Andrew L.</au><au>Link, Brian K.</au><au>Delamain, Marcia Torresan</au><au>Spina, Michele</au><au>Annibali, Ombretta</au><au>Pulsoni, Alessandro</au><au>Ferreri, Andrés J.M.</au><au>Stelitano, Caterina Cecilia</au><au>Pennese, Elsa</au><au>Habermann, Thomas M.</au><au>Marcheselli, Luigi</au><au>Han, Sunwoo</au><au>Reis, Isildinha M.</au><au>Paulli, Marco</au><au>Lossos, Izidore S.</au><au>Cerhan, James R.</au><au>Luminari, Stefano</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Marginal zone lymphoma international prognostic index: a unifying prognostic index for marginal zone lymphomas requiring systemic treatment</atitle><jtitle>EClinicalMedicine</jtitle><addtitle>EClinicalMedicine</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>72</volume><spage>102592</spage><pages>102592-</pages><artnum>102592</artnum><issn>2589-5370</issn><eissn>2589-5370</eissn><abstract>Marginal zone lymphomas (MZL), comprised of three unique but related subtypes, lack a unifying prognostic score applicable to all the patients in need for systemic chemotherapy and/or immunotherapy.
Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontline systemic therapy at diagnosis or after observation were used to train a prognostic model. The primary endpoint was progression-free survival (PFS) from start of treatment. The model was externally validated in a pooled analysis of two independent cohorts from the University of Iowa and Mayo Clinic Molecular Epidemiology Resource and the University of Miami.
We identified 501 eligible patients. After multivariable modeling, lactate dehydrogenase (LDH) above upper normal limit, hemoglobin <12 g/dL, absolute lymphocyte count <1 × 109/L, platelets <100 × 109/L, and MZL subtype (nodal or disseminated) were independently associated with inferior PFS. The proposed MZL International Prognostic index (MZL-IPI) combined these 5 factors, and we defined low (LRG, 0 factors, 27%), intermediate (IRG, 1–2 factors, 57%) and high (HRG, 3+ factors, 16%) risk groups with 5-y PFS of 85%, 66%, and 37%, respectively (c-Harrell = 0.64). Compared to the LRG, the IRG (Hazard Ratio [HR] = 2.30, 95% CI 1.39–3.80) and HRG (HR = 5.41, 95% CI 3.12–9.38) had inferior PFS. Applying the MZL-IPI to the pooled US cohort (N = 353), 94 (27%), 192 (54%), and 67 (19%) patients were classified as LRG, IRG, and HRG, respectively, and the model was validated for PFS (log-rank test p = 0.0018; c-Harrell = 0.578, 95% CI 0.54–0.62). The MZL-IPI was also prognostic for OS in both the training and the external validation sets.
MZL-IPI is a new prognostic score for use in all patients with MZL considered for systemic treatment.
The MER was supported by P50 CA97274 and U01 CA195568.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38633575</pmid><doi>10.1016/j.eclinm.2024.102592</doi><orcidid>https://orcid.org/0000-0002-0905-5927</orcidid><orcidid>https://orcid.org/0000-0002-0432-9706</orcidid><orcidid>https://orcid.org/0000-0002-9504-991X</orcidid><orcidid>https://orcid.org/0000-0001-8446-2285</orcidid><orcidid>https://orcid.org/0000-0002-2690-3377</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | EClinicalMedicine, 2024-06, Vol.72, p.102592, Article 102592 |
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| source | DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Marginal zone lymphoma Prognosis |
| title | Marginal zone lymphoma international prognostic index: a unifying prognostic index for marginal zone lymphomas requiring systemic treatment |
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