Factors affecting refractoriness or recurrence in diffuse large B-cell lymphoma: development and validation of a novel predictive nomogram
Background Relapsed/Refractory (R/R) diffuse large B-cell lymphoma (DLBCL) represents a subgroup with a high incidence and dismal prognosis. Currently, there is a lack of robust models for predicting R/R DLBCL. Therefore, we conducted a retrospective study to identify key determinants to be incorpor...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Hematology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/16078454.2024.2445395 |
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| author | Yiwei Guo Jie Lian Yao Chen Lina Quan Xiuchen Guo Jingbo Zhang Zhiqiang Liu Aichun Liu |
| author_facet | Yiwei Guo Jie Lian Yao Chen Lina Quan Xiuchen Guo Jingbo Zhang Zhiqiang Liu Aichun Liu |
| author_sort | Yiwei Guo |
| collection | DOAJ |
| description | Background Relapsed/Refractory (R/R) diffuse large B-cell lymphoma (DLBCL) represents a subgroup with a high incidence and dismal prognosis. Currently, there is a lack of robust models for predicting R/R DLBCL. Therefore, we conducted a retrospective study to identify key determinants to be incorporated into a novel nomogram to enhance the identification of DLBCL patients at elevated risk of refractoriness/recurrence.Methods We included 293 newly-diagnosed DLBCL patients from Harbin Medical University Cancer Hospital, collected from 2008–2017. Patients were randomly divided into a training cohort (n = 206) and a validation cohort (n = 87) at a 7:3 ratio. The training cohort underwent univariable analysis to select variables for a binary logistic regression model. These variables were also prioritized using a random forest algorithm. The developed nomogram was evaluated with the receiver-operator characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) for its clinical utility.Results Univariable analysis pinpointed several factors significantly associated with refractoriness/recurrence, including pathological subtype, lactate dehydrogenase (LDH), International Prognostic Index (IPI), treatment, absolute lymphocyte count (ALC), lymphocyte/monocyte ratio (LMR), and prognostic nutritional index (PNI). Binary logistic regression highlighted pathological subtype, LDH, treatment, and ALC as key predictors, which were incorporated into the nomogram. The nomogram showed excellent calibration and accuracy in both cohorts, and comparative DCA and ROC analysis demonstrated its superior net benefit and area under the curve (AUC) compared to traditional indexes like IPI, R-IPI, and NCCN-IPI.Conclusion This nomogram serves as a valuable tool for predicting the likelihood of refractoriness or recurrence in DLBCL patients. |
| format | Article |
| id | doaj-art-7c7c126c9de2469dbc558fd80715623c |
| institution | Kabale University |
| issn | 1607-8454 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Hematology |
| spelling | doaj-art-7c7c126c9de2469dbc558fd80715623c2024-12-26T08:25:52ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2024.2445395Factors affecting refractoriness or recurrence in diffuse large B-cell lymphoma: development and validation of a novel predictive nomogramYiwei Guo0Jie Lian1Yao Chen2Lina Quan3Xiuchen Guo4Jingbo Zhang5Zhiqiang Liu6Aichun Liu7Hematology Department, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of ChinaOutpatient Chemotherapy Department, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of ChinaHematology Department, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of ChinaHematology Department, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of ChinaHematology Department, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of ChinaHematology Department, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of ChinaHematology Department, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of ChinaHematology Department, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of ChinaBackground Relapsed/Refractory (R/R) diffuse large B-cell lymphoma (DLBCL) represents a subgroup with a high incidence and dismal prognosis. Currently, there is a lack of robust models for predicting R/R DLBCL. Therefore, we conducted a retrospective study to identify key determinants to be incorporated into a novel nomogram to enhance the identification of DLBCL patients at elevated risk of refractoriness/recurrence.Methods We included 293 newly-diagnosed DLBCL patients from Harbin Medical University Cancer Hospital, collected from 2008–2017. Patients were randomly divided into a training cohort (n = 206) and a validation cohort (n = 87) at a 7:3 ratio. The training cohort underwent univariable analysis to select variables for a binary logistic regression model. These variables were also prioritized using a random forest algorithm. The developed nomogram was evaluated with the receiver-operator characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) for its clinical utility.Results Univariable analysis pinpointed several factors significantly associated with refractoriness/recurrence, including pathological subtype, lactate dehydrogenase (LDH), International Prognostic Index (IPI), treatment, absolute lymphocyte count (ALC), lymphocyte/monocyte ratio (LMR), and prognostic nutritional index (PNI). Binary logistic regression highlighted pathological subtype, LDH, treatment, and ALC as key predictors, which were incorporated into the nomogram. The nomogram showed excellent calibration and accuracy in both cohorts, and comparative DCA and ROC analysis demonstrated its superior net benefit and area under the curve (AUC) compared to traditional indexes like IPI, R-IPI, and NCCN-IPI.Conclusion This nomogram serves as a valuable tool for predicting the likelihood of refractoriness or recurrence in DLBCL patients.https://www.tandfonline.com/doi/10.1080/16078454.2024.2445395Diffuse large B-cell lymphomarefractorinessrecurrenceclinical indicatornomogram |
| spellingShingle | Yiwei Guo Jie Lian Yao Chen Lina Quan Xiuchen Guo Jingbo Zhang Zhiqiang Liu Aichun Liu Factors affecting refractoriness or recurrence in diffuse large B-cell lymphoma: development and validation of a novel predictive nomogram Hematology Diffuse large B-cell lymphoma refractoriness recurrence clinical indicator nomogram |
| title | Factors affecting refractoriness or recurrence in diffuse large B-cell lymphoma: development and validation of a novel predictive nomogram |
| title_full | Factors affecting refractoriness or recurrence in diffuse large B-cell lymphoma: development and validation of a novel predictive nomogram |
| title_fullStr | Factors affecting refractoriness or recurrence in diffuse large B-cell lymphoma: development and validation of a novel predictive nomogram |
| title_full_unstemmed | Factors affecting refractoriness or recurrence in diffuse large B-cell lymphoma: development and validation of a novel predictive nomogram |
| title_short | Factors affecting refractoriness or recurrence in diffuse large B-cell lymphoma: development and validation of a novel predictive nomogram |
| title_sort | factors affecting refractoriness or recurrence in diffuse large b cell lymphoma development and validation of a novel predictive nomogram |
| topic | Diffuse large B-cell lymphoma refractoriness recurrence clinical indicator nomogram |
| url | https://www.tandfonline.com/doi/10.1080/16078454.2024.2445395 |
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