Central nervous system international prognostic index impacts overall survival in diffuse large b-cell lymphoma treated with r-chop in a third level cancer center from Mexico: a survey of 642 patients

Background: Central nervous system international prognosis index (CNS-IPI) is validated in European and the USA cancer databases. However, no validation has been done in Mexican population. Objective: The objective of the study was to assess the impact of the CNS-IPI on central nervous system (CNS) relapse and survival in Mexican patients with diffuse large B-cell lymphoma (DLBCL). Methods: In this retrospective analysis, clinical, biochemical, and histological variables and the CNS-IPI were analyzed. Results: Six hundred and forty-two patients with DBLCL were included in the study. The mean ± SD age was 56.8 ± 14.9 years. Most had an ECOG of 0-1: 75% (n = 484) had absence of B-symptoms and advanced disease (clinical stage: III-IV, n = 433, 67.4%). According to the CNS-IPI, almost one-half were in the low-risk category. According to the CNS-IPI, CNS relapse rate was 1.36% (95% CI: 83.2-92.8), 3.1% (95% CI: 132.4-162.8), and 7.4% (95% CI 61-91) for patients in the low-, intermediate-, and high-risk categories, respectively. The median overall survival in the high-risk group (CNS-IPI) was 22 months, and it has not been achieved after 80 months of follow-up for the other groups. Conclusions: CNS-IPI was associated with survival; therefore, we propose its use as a prognostic tool for prospective validation.

The establishment of ischemic stroke recurrence prediction model and its application value / 中华老年医学杂志

Objective To establish a prediction model for 3-years recurrence after initial ischemic stroke by Cox proportional hazards regression and individual prognostic Index(PI)equation, and to evaluate its application value and external reality. Methods The inpatients with cerebral ischemic stroke hospitalized in Neurology Department in North China University of Science and Technology Affiliated Hospital were finally internalized between January 2013 and December 2013.Follow-up study on recurrence was carried out between January 2016 and December 2016.The recurrence prediction model was constructed by the Cox proportional hazards regression model.During January 2016 and December 2016,data of patients with ischemic stroke were prospectively continuously collected.And PI equation was used to verify its external reality in ischemic stroke patients. Results A total of 184 cases had stroke recurrence during the follow-up period.The Cox proportional hazards regression model analysis showed that age(RR=1.303,95% CI:1.019-1.666),history of heart disease(RR=1.788,95% CI:1.127-2.836),hypertension(RR=1.897,95% CI:1.097-3.280),diabetes(RR= 1.674,95% CI:1.015-2.760)and total cholesterol(RR= 2.136,95% CI:1.396-3.266)were the independent risk factors for stroke recurrence.The established recurrence model was correlated with individual PI equation,which was PI = 0.265X1+ 0.581X2+ 0.640X3+ 0.515X4+0.759X5.By the validation study of PI equation to predict stroke recurrence among patients admitted later, the sensitivity was 0.719,specificity was 0.769,and accuracy was 0.800. Conclusions Age,history of heart disease,hypertension,diabetes,and total cholesterol are independent risk factors for recurrence of ischemic stroke.And the PI for predicting stroke recurrence within 3 years after initial stroke is successfully established,which is good and helpful for predicting ischemic stroke recurrence.

Cox regression analysis of risk factors and establishment of prediction model for recurrent acute ischemic stroke in 3-years follow-up / 中华行为医学与脑科学杂志

Objective To investigate the risk factors and establish the Cox's regression model and the personal prognosis index for the recurrence of ischemic stroke in 3-year follow-up.methods 1058 patients were retrospectively reviewed consecutively diagnosed with ischemic stroke admitted to the Neurology Department of the Hebei united University Affiliated Hospital from January 1,2013 to December 31,2013.Cases were followed up since the onset of ischemic stroke.The follow-up was finished in January 1,2016.Kaplan-Meier methods were used for recurrence rate description.Monovariant and multivariate Cox's proportional hazard regression model were used to analyze risk factors associated with recurrence.Thus,a recurrence model was set up.Result sDuring the period of follow-up,184 cases relapsed.The 1-year recurrence rate was 29.9 person-year,2-year recurrence rate was 46.6 person-year,3-year recurrence rate was 52.7 person-year.Monovariant and multivariant Cox's proportional hazard regression model showed that the independent risk factors associated with recurrence were age(X1)(RR=1.303;95%CI:1.019~1.666)history of heart disease(X2)(RR=1.788;95%CI:1.127~2.836),hypertension(X3)(RR=1.897;95%CI:1.097~3.280),diabetes(X4)(RR=1.674;95%CI:1.015~2.760),total cholesterol(X5)(RR=2.136;95%CI:1.396~3.266).The personal prognosis index(PI)of recurrence model was as the following: PI=0.265X1+0.581X2+0.640X3+0.515X4+0.759X5.Conclusion sAge,history of heart disease,hypertension,disease progression,and total cholesterol are the independent risk factors associated with recurrence of ischemic stroke.The recurrence model and the personal prognosis index equation are successful constructed.

Relationship between the international prognosis indexes and the cell-mediated immunity condition in DLBCL patients / 白血病·淋巴瘤

ObjectiveTo explore the relationship between the international prognosis indexes(IPT) and the cell-mediated immunity condition in DLBCL patients. Methods52 DLBCL patients were divided into 4 groups and the FCM was used to examine the T lymphocyte subsets,including CD3+、CD4+、CD8+、NK cells.T lymphocyte subsets absolute value and CD4+/CD8+ ratio were examined. Correlation with IPI were compared among groups.ResultsCD3+ cells in high risk group [(1570.9±370.5)/μl]were higher than other IPI groups;CD4+ cells in DLBCL groups were all lower than normal group(751.3±367.4)/μl]; CD8+ cells in high risk group [(1055.9±523.8)/μl] were higher than other groups; CD4+/CD8+ ratio in middle-high risk group and high risk group (1.0±0.2、0.7±1.0)were lower than other IPI groups and normal group;NK cells in middle-high risk group and high risk group were lower than the normal group[(199.5±68.4)/μl、(171.9±126.9)/μl];Age,clinical stage,body state had correlated with the CD3+ 、CD8+ cells and CD4+/CD8+ ratio of the DLBCL patients' peripheralblood T lymphosyte subsets. ConclusionsThe immunity condition in DLBCL patients has correlated with IPI; With increasing IPI value,the immunity depression and disorder become more serious,NK cells function become worse,and the prognosis is bad too.

Risk factors on the recurrence of ischemic stroke and the establishment of a Cox' s regression model / 中华流行病学杂志

Objective To investigate the risk factors and establish the Cox' s regression model on the recurrence of ischemic stroke. Methods We retrospectively reviewed consecutive patients with ischemic stroke admitted to the Neurology Department of the Hebei United University Affiliated Hospital between January 1,2008 and December 31,2009. Cases had been followed since the onset of ischemic stroke. The follow-up program was finished in June 30, 2010. Kaplan-Meier methods were used to describe the recurrence rate. Monovariant and multivariate Cox' s proportional hazard regression model were used to analyze the risk factors associated to the episodes of recurrence.And then, a recurrence model was set up. Results During the period of follow-up program, 79 cases were relapsed,with the recurrence rates as 12.75% in one year and 18.87% in two years. Monovariant and multivariate Cox' s proportional hazard regression model showed that the independent risk factors that were associated with the recurrence appeared to be age (X1)(RR=1.025,95% CI: 1.003-1.048),history of hypertension (X2) (RR= 1.976, 95% CI: 1.014-3.851), history of family strokes (X3) (RR=2.647,95%CI: 1.175-5.961), total cholesterol amount (X4) (RR= 1.485,95%CI: 1.214-1.817), ESRS total scores (X5) (RR= 1.327,95%CI: 1.057-1.666) and progression of the disease (X6) (RR= 1.889,95%CI: 1.123-3.178). Personal prognosis index (PI) of the recurrence model was as follows: PI=0.025X1 + 0.681X2+ 0.973X3 + 0.395X4+ 0.283X5 + 0.636X6. The smaller the personal prognosis index was, the lower the recurrence risk appeared, while the bigger the personal prognosis index was, the higher the recurrence risk appeared. Conclusion Age, history of hypertension, total cholesterol amount, total scores of ESRS, together with the disease progression were the independent risk factors associated with the recurrence episodes of ischemic stroke. Both recurrence model and the personal prognosis index equation were successful constructed.

Application of Treatment-dependent Prognosis Index (TPI) for determination of the prognosis in the cases of Oral Squamous Cell Carcinoma

Applied TNM-system for determination and prognostic classification of the cancer patients of Oral and Maxillofacial region does, however, only partly justice, if at all, to the nature of the tumor disease. And the TNM-system implies among other defects a crude simplification of the complex pattern of the tumor disease. But in clinical practice, the prognosis must be determined on the bases of a specific combination of clinical factors under consideration of various therapeutical conditions. For more reliable and objective prognosis determination for the cancer patients of Oral and Maxillofacial region, `Retrospective DOSAK(German-Austrian-Swiss Association for Head and Neck Tumors) study' introduced Treatment-dependent Prognosis Index TPI in 1982. Treatment-dependent Prognosis Index TPI gives the clinician an opportunity to determine the prognosis before starting therapy at the time of the first admission of the patient, during the therapy and immediately after complete of the therapy. The fundamental purpose of the TPI can be summarized as follows. 1) In clinical-therapeutical cancer research the TPI provides a sound basis for the planning and verification of therapy studies. 2) In clinical practice the TPI allows a reliable and objective determination of the prognosis for the individual patient and thus provides the clinician valuable assistance in planning the treatment. The authors estimated the survival curves of the 179 cases of squamous cell carcinoma from 1985.1.1 to 1992.8.31 in the Department of Oral and Maxillofacial Surgery, Seoul National University Hospital according to Treatment-dependent Prognosis Index TPI of Retrospective DOSAK study and compared with the survival curves observed in long term study on prognosis of patients.