A Visual Nomogram Survival Prediction Model in Acquired Immune Deficiency Syndrome (AIDS)-Related Diffuse Large...

Area of Science:

• Oncology
• Infectious Diseases
• Biostatistics

Background:

• Prognosticating newly diagnosed AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) presents significant challenges.
• Existing models may not fully capture the complexities of AR-DLBCL patient outcomes.

Purpose of the Study:

• To develop and validate a novel visual nomogram, the ARDPI model, for predicting survival in patients with newly diagnosed AR-DLBCL.
• To compare the predictive accuracy of the ARDPI model against established prognostic indices like IPI and NCCN-IPI.

Main Methods:

• A prospective, multicenter cohort study involving 306 consecutive subjects was conducted.
• Data from a training cohort (N=215) and an external validation cohort (N=91) were utilized.
• The ARDPI model was developed using seven independent co-variates: age, LMR, CD5, blood EBV-DNA copy number, CD4/CD8 ratio, CNS involvement, and anti-HIV therapy (ART).

Main Results:

• The ARDPI model demonstrated strong predictive performance with Area Under the Receiver Operating Characteristic Curves (AUROCs) for 1-, 3-, and 5-year survivals ranging from 0.77 to 0.85.
• The model's accuracy surpassed that of the International Prognostic Index (IPI) and the National Comprehensive Cancer Network-IPI (NCCN-IPI) models.
• Three distinct risk groups with significantly different 3-year survival rates (88%, 35%, 23% in training; 93%, 46%, 17% in validation) were identified using the ARDPI model.

Conclusions:

• The ARDPI model provides accurate survival predictions for newly diagnosed AR-DLBCL patients.
• The model offers clinical benefits and demonstrates superior accuracy compared to IPI and NCCN-IPI.
• A web server has been developed to enhance the accessibility and clinical utility of the ARDPI model.