title: Risk stratification for Splenic Marginal Zone Lymphoma based on haemoglobin concentration, platelet count, high lactate dehydrogenase level and extrahilar lymphadenopathy: development and validation on 593 cases.
abstract: This international retrospective study of 593 Splenic Marginal Zone Lymphoma (SMZL) patients aimed to identify factors that determine treatment initiation and influence lymphoma-specific survival (LSS). Logistic regression was used to identify the factors associated with treatment. A Cox regression was used to analyse LSS in a derivation cohort of 366 patients. This produced a prognostic index (PI) and enabled the identification of three risk groups. The resulting stratification was validated in another cohort of 227 patients and compared with the Interguppo Italiano Linfomi (IIL) score in the group of 450 patients for whom all the required data were available using an extension of the net reclassification improvement. Haemoglobin concentration (Hb), extrahilar lymphadenopathy and hepatitis C virus status were associated with the initiation of treatment. Hb, platelet count, high lactate dehydrogenase level and extrahilar lymphadenopathy were independently associated with LSS. Three risk groups with significantly different five-year LSS (94%, 78% and 69%, respectively) were identified. This stratification (named HPLL on the basis of determinant factors) had a better discriminative power than the IIL score. This system is useful for stratifying SMZL patients into risk groups and may help in the selection of risk-tailored treatment approaches.
authors.affiliation: Department of Internal Medicine, Hospital Ramon y Cajal/IRYCIS, Carretera de Colmenar Km 9, Madrid, Spain. cmontalban.hrc@salud.madrid.org
authors.forename: Carlos
authors.initials: C
authors.lastname: Montalbán
authors.forename: Víctor
authors.initials: V
authors.lastname: Abraira
authors.forename: Luca
authors.initials: L
authors.lastname: Arcaini
authors.forename: Eva
authors.initials: E
authors.lastname: Domingo-Domenech
authors.forename: Pablo
authors.initials: P
authors.lastname: Guisado-Vasco
authors.forename: Emilio
authors.initials: E
authors.lastname: Iannitto
authors.forename: Emilio
authors.initials: E
authors.lastname: Iannito
authors.forename: Manuela
authors.initials: M
authors.lastname: Mollejo
authors.forename: Estella
authors.initials: E
authors.lastname: Matutes
authors.forename: Andrés
authors.initials: A
authors.lastname: Ferreri
authors.forename: Antonio
authors.initials: A
authors.lastname: Salar
authors.forename: Sara
authors.initials: S
authors.lastname: Rattotti
authors.forename: Andrea
authors.initials: A
authors.lastname: Carpaneto
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pérez Fernández
authors.forename: José L
authors.initials: JL
authors.lastname: Bello
authors.forename: Miguel
authors.initials: M
authors.lastname: Hernández
authors.forename: Dolores
authors.initials: D
authors.lastname: Caballero
authors.forename: Felix
authors.initials: F
authors.lastname: Carbonell
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Piris
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000097:blood / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D012307:Risk Factors; D013160:Splenic Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy; D015996:Survival Rate
chemical_list: D006454:Hemoglobins; D007770:L-Lactate Dehydrogenase