Validation of prognostic models in elderly patients with diffuse large B-cell lymphoma in a real-world nationwide population-based study - development of a clinical nomogram

Jelena Jelicic ¹, Karen Juul-Jensen ¹, Zoran Bukumiric ²

¹Department of Hematology, Odense University Hospital, Odense, Denmark.
²Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
³Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
⁴Department of Mathematical Sciences, Aalborg University, Aalborg, Denmark.
⁵Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
⁶Department of Hematology, Vejle Hospital, Sygehus Lillebaelt, Vejle, Denmark.
⁷Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.
⁸Department of Hematology, Regional Hospital Gødstrup, Gødstrup, Denmark.
⁹Department of Hematology, Zealand University Hospital, Roskilde, Denmark.
¹⁰Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
¹¹Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
¹²Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
¹³Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
¹⁴Department of Hematology, Odense University Hospital, Odense, Denmark. Thomas.stauffer.larsen@rsyd.dk.
¹⁵Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Thomas.stauffer.larsen@rsyd.dk.

⁰Department of Hematology, Odense University Hospital, Odense, Denmark.

Annals of Hematology +

|

December 31, 2024

View abstract on PubMed

Summary

The International Prognostic Index (IPI) has limitations for older diffuse large B-cell lymphoma (DLBCL) patients. A new nomogram model offers superior, individualized predictions for this age group.

Area Of Science

Hematology
Oncology
Clinical Epidemiology

Background

The International Prognostic Index (IPI) is widely used for diffuse large B-cell lymphoma (DLBCL) prognostication.
Existing models often lack accuracy for elderly patients (over 60).

Purpose Of The Study

To validate and compare existing prognostic models for elderly DLBCL patients.
To develop a novel, accurate nomogram for individualized prognostication in this population.

Main Methods

Validation of six prognostic models (IPI, R-IPI, NCCN-IPI, E-IPI, aaIPI) in 2,835 elderly DLBCL patients.
Development and verification of a clinical nomogram using NCCN-IPI variables, albumin, and platelet levels.

Main Results

Elderly IPI (E-IPI) and age-adjusted IPI (aaIPI) showed improved accuracy but failed to identify a distinct high-risk group.
The developed nomogram demonstrated superior discriminatory ability and precision compared to all other models.
The nomogram provided more accurate individual predictions for elderly DLBCL patients.

Conclusions

Traditional prognostic models are insufficient for accurately predicting outcomes in elderly DLBCL patients.
Nomogram-based models are recommended for this population to avoid information loss from variable dichotomization.
The novel nomogram offers a more precise tool for individualized risk assessment in older adults with DLBCL.

Keywords:

Elderly Nomogram Prognostic models To index the content: diffuse large B cell lymphoma Validation

Related Concept Videos

Cancer Survival Analysis

Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...