Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL
BackgroundDespite the introduction of combined antiretroviral therapy, AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) remains a prominent cancer among individuals living with HIV with a suboptimal prognosis. Identifying independent prognostic markers could improve risk stratification.MethodsI...
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1354325/full |
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| author | Juanjuan Chen Juanjuan Chen Yihua Wu Yihua Wu Han Zhao Han Zhao Han Zhao Guangjing Ruan Shanfang Qin |
| author_facet | Juanjuan Chen Juanjuan Chen Yihua Wu Yihua Wu Han Zhao Han Zhao Han Zhao Guangjing Ruan Shanfang Qin |
| author_sort | Juanjuan Chen |
| collection | DOAJ |
| description | BackgroundDespite the introduction of combined antiretroviral therapy, AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) remains a prominent cancer among individuals living with HIV with a suboptimal prognosis. Identifying independent prognostic markers could improve risk stratification.MethodsIn this multicenter retrospective cohort study spanning years 2011 to 2019, 153 eligible patients with AR-DLBCL were examined. Overall survival (OS) factors were analyzed using Kaplan–Meier curves, and univariate and multivariate Cox proportional hazards models. The discriminatory ability of the risk score was evaluated by examining the area under the receiver operating characteristic curve.ResultsThe study included 153 patients with a median age of 47 years (interquartile range [IQR] 39–58), 83.7% of whom were men. The median follow-up was 12.0 months (95% confidence interval [CI], 8.5–15.5), with an OS rate of 35.9%. Among the potential inflammatory markers examined, only the ratio of hemoglobin (g/dL) to red cell distribution width (%) (Hb/RDW) emerged as an independent prognostic parameter for OS in the training (hazard ratios [HR] = 2.645, 95% CI = 1.267–5.522, P = 0.010) and validation cohorts (HR = 2.645, 95% CI = 1.267–5.522, P = 0.010). A lower Hb/RDW ratio was strongly correlated with adverse clinical factors, including advanced Ann Arbor stage, increased extranodal sites, reduced CD4 count, elevated lactate dehydrogenase levels, poorer Eastern Cooperative Oncology Group performance status (ECOG PS), and a higher International Prognostic Index (IPI) score. The addition of the Hb/RDW ratio to the IPI produced a highly discriminatory prognostic composite score, termed Hb/RDW-IPI.ConclusionWe identified a cost-effective and readily available inflammatory biomarker, the Hb/RDW ratio, as an independent predictor of outcomes in patients with AR-DLBCL. Its integration into the IPI score partially improves prognostic accuracy. |
| first_indexed | 2024-03-08T00:50:42Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-03-08T00:50:42Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj.art-267488980ece4dda9af1b377acf830912024-02-15T04:32:08ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-02-011510.3389/fimmu.2024.13543251354325Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCLJuanjuan Chen0Juanjuan Chen1Yihua Wu2Yihua Wu3Han Zhao4Han Zhao5Han Zhao6Guangjing Ruan7Shanfang Qin8Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaState Key Laboratory of Organ Failure Research, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Guangdong Institute of Hepatology, Guangzhou, ChinaDepartment of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaState Key Laboratory of Organ Failure Research, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Guangdong Institute of Hepatology, Guangzhou, ChinaDepartment of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaState Key Laboratory of Organ Failure Research, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Guangdong Institute of Hepatology, Guangzhou, ChinaInfectious Diseases Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, ChinaGuangxi AIDS Clinical Treatment Center, The Fourth People’s Hospital of Nanning, Nanning, ChinaGuangxi AIDS Diagnosis and Treatment Quality Control Center, Chest Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, ChinaBackgroundDespite the introduction of combined antiretroviral therapy, AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) remains a prominent cancer among individuals living with HIV with a suboptimal prognosis. Identifying independent prognostic markers could improve risk stratification.MethodsIn this multicenter retrospective cohort study spanning years 2011 to 2019, 153 eligible patients with AR-DLBCL were examined. Overall survival (OS) factors were analyzed using Kaplan–Meier curves, and univariate and multivariate Cox proportional hazards models. The discriminatory ability of the risk score was evaluated by examining the area under the receiver operating characteristic curve.ResultsThe study included 153 patients with a median age of 47 years (interquartile range [IQR] 39–58), 83.7% of whom were men. The median follow-up was 12.0 months (95% confidence interval [CI], 8.5–15.5), with an OS rate of 35.9%. Among the potential inflammatory markers examined, only the ratio of hemoglobin (g/dL) to red cell distribution width (%) (Hb/RDW) emerged as an independent prognostic parameter for OS in the training (hazard ratios [HR] = 2.645, 95% CI = 1.267–5.522, P = 0.010) and validation cohorts (HR = 2.645, 95% CI = 1.267–5.522, P = 0.010). A lower Hb/RDW ratio was strongly correlated with adverse clinical factors, including advanced Ann Arbor stage, increased extranodal sites, reduced CD4 count, elevated lactate dehydrogenase levels, poorer Eastern Cooperative Oncology Group performance status (ECOG PS), and a higher International Prognostic Index (IPI) score. The addition of the Hb/RDW ratio to the IPI produced a highly discriminatory prognostic composite score, termed Hb/RDW-IPI.ConclusionWe identified a cost-effective and readily available inflammatory biomarker, the Hb/RDW ratio, as an independent predictor of outcomes in patients with AR-DLBCL. Its integration into the IPI score partially improves prognostic accuracy.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1354325/fullHb/RDW ratioaidsdiffuse large B-cell lymphomaprognostic biomarkerinflammatory index |
| spellingShingle | Juanjuan Chen Juanjuan Chen Yihua Wu Yihua Wu Han Zhao Han Zhao Han Zhao Guangjing Ruan Shanfang Qin Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL Frontiers in Immunology Hb/RDW ratio aids diffuse large B-cell lymphoma prognostic biomarker inflammatory index |
| title | Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL |
| title_full | Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL |
| title_fullStr | Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL |
| title_full_unstemmed | Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL |
| title_short | Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL |
| title_sort | ratio of hemoglobin to red cell distribution width an inflammatory predictor of survival in aids related dlbcl |
| topic | Hb/RDW ratio aids diffuse large B-cell lymphoma prognostic biomarker inflammatory index |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1354325/full |
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