A Prognostic Model for the Progression of Diffuse Large B-cell Lymphoma after Treatment Involving Traditional Chinese Medicine Factors
Objective;To establish a risk model for progression after chemotherapy in diffuse large B-cell lymphoma(DLBCL)in-volving traditional Chinese medicine(TCM)factors,providing a basis for DLBCL treatment.Methods:A retrospective analysis was conducted on 110 newly diagnosed DLBCL patients from Shanghai Municipal Hospital of Traditional Chinese Medicine between Jan-uary 2014 and December 2020.Patients were divided into an observation group(32 cases)and a control group(78 cases)based on relapse status,with a 2-year follow-up.The analysis incorporated 13 variables,including age,Karnofsky Performance Status(KPS),Eastern Cooperative Oncology Group(ECOG)performance status,number of comorbidities,duration of Chinese medicine usage,sex,disease stage,B symptoms(a.unexplained fever,non-infectious fever,body temperature＞38 ℃;b.night sweats;c.weight loss of ≥ 10％in the past 6 months.Any one of these indicates B symptoms),number of involved lymph nodes≥5,large masses,extran-odal involvement,germinal center,initial treatment outcome,and Chinese medicine usage.LASSO regression and multivariate Cox regression were used to develop a nomogram model,analyzing whether Chinese medicine usage and duration could improve the prog-nosis of DLBCL patients.Model performance was assessed using receiver operating characteristic(ROC)curves,area under the curve(AUC),decision curve analysis(DCA),and calibration curves,with Bootstrap resampling to verify model stability.Results:LASSO and Cox regression results indicated that TCM factors,specifically Chinese medicine usage duration,were protective factors for progression-free survival(PFS)in DLBCL(P＜0.05),while the number of comorbidities,large masses,and initial treatment outcome were risk factors for DLBCL PFS(P＜0.05).The model integrated these variables,with ROC curve AUCs at 6,12,and 24 months of 0.85,0.93,and 0.92,respectively,all higher than individual risk factors.The calibration curve was close to the ideal line.Conclusion:This study established a nomogram prognostic model for post-chemotherapy progression in DLBCL patients based on the influencing factors identified by LASSO and Cox regressions,i.e.,Chinese medicine usage duration,number of comorbidi-ties,large masses,and initial treatment outcome.After internal validation through Bootstrap resampling,the model showed good per-formance and stability,accurately predicting the risk of relapse in DLBCL patients at 6,12,and 24 months after chemotherapy.
Diffuse large B-cell lymphomaProgression-free survivalClinical prognostic modelTraditional Chinese medicine factorsNomogram
万方数据
维普
