title: The prognostic role of systemic inflammatory markers on HIV-infected patients with non-Hodgkin lymphoma, a multicenter cohort study.
abstract: BACKGROUND
  The systemic inflammatory response has been postulated as having prognostic significance in a wide range of different cancer types. We aimed to assess the prognostic role of inflammatory markers on survival in HIV-infected patients with Non-Hodgkin Lymphoma (NHL), and to compute a prognostic score based on inflammatory biomarkers.
  
  
  METHODS
  We evaluated data on HIV patients with NLH diagnosis between 1998 and 2012 in a HIV Italian Cohort. Using Cox proportional regression model, we assessed the prognostic role of Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), and Prognostic Nutritional Index (PNI). We also computed a risk score equation, assigning patients to a derivation and a validation sample. The area under the curve (AUC) was use to evaluate the predictive ability of this score.
  
  
  RESULTS
  215 non-Hodgkin lymphoma cases (80.0% males) with a mean age of 43.2 years were included. Deaths were observed in 98 (45.6%) patients during a median follow up of 5 years. GPS, mGPS, PI and PNI were independently associated with risk of death. We also computed a mortality risk score which included PNI and occurrence of an AIDS event within six months from NHL diagnosis. The AUCs were 0.69 (95% CI 0.58 to 0.81) and 0.69 (95% CI 0.57 to 0.81) at 3 and 5 years of the follow-up, respectively.
  
  
  CONCLUSIONS
  GPS, mGPS, PI and PNI are independent prognostic factors for survival of HIV patients with NHL.
authors.affiliation: Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy. e.raffetti@unibs.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Raffetti
authors.affiliation: Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy. francesco.donato@unibs.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Donato
authors.affiliation: Hospital Division of Infectious and Tropical Diseases, Spedali Civili Hospital, Brescia, Italy. filippo.castelnuovo@tiscali.it.
authors.forename: Filippo
authors.initials: F
authors.lastname: Castelnuovo
authors.affiliation: Department of Infectious Diseases, Polyclinic of Bari, University of Bari, Bari, Italy. nladisa@hotmail.com.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Ladisa
authors.affiliation: University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. g.paraninfo@infettivibrescia.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paraninfo
authors.affiliation: Department of Infectious Diseases of Papa Giovanni XXIII Hospital, Bergamo, Italy. elisadifilippo@libero.it.
authors.forename: Elisa
authors.initials: E
authors.lastname: Di Filippo
authors.affiliation: Department of Infectious Diseases, S. Anna Hospital, Ferrara, Italy. l.sighinolfi@ospfe.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Segala
authors.affiliation: Department of Infectious Diseases of Papa Giovanni XXIII Hospital, Bergamo, Italy. gcologni@ospedaliriuniti.bergamo.it.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Cologni
authors.affiliation: Department of Infectious Diseases, San Gerardo de' Tintori" Hospital, Monza, Italy. a.bandera@hsgerardo.org.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bandera
authors.affiliation: Clinical Infectious Diseases, Istituti Ospitalieri, Cremona, Italy. zacchi.fabio@virgilio.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Zacchi
authors.affiliation: Institute of Clinical Infectious Diseases, Polyclinic A. Gemelli, University of Sacred Heart, Rome, Italy. simona.digiambenedetto@rm.unicatt.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Digiambenedetto
authors.affiliation: Department of Infectious Diseases, SM. Annunziata Hospital, Florence, Italy. m.dipietro@ausl.toscana.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Pietro
authors.affiliation: University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. francesco.castelli@unibs.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.affiliation: University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. eugeniaquiros@yahoo.it.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Quiros-Roldan
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000378:metabolism; D001792:Blood Platelets / Q000166:cytology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D008214:Lymphocytes / Q000166:cytology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D009752:Nutritional Status; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012044:Regression Analysis
chemical_list: D015415:Biomarkers