巴西霍奇金淋巴瘤注册表中的整体财团高级霍奇金淋巴瘤国际预后指数（A-IPHI）的外部验证和校准
External validation and calibration of the HoLISTIC Consortium's advanced-stage Hodgkin lymphoma international prognostic index (A-HIPI) in the Brazilian Hodgkin lymphoma registry
影响因子:3.80000
分区:医学2区 / 血液学2区
发表日期:2025 Jan
作者:
Valeria Buccheri, Frederico Rafael Moreira, Irene Biasoli, Nelson Castro, Carolina Colaço Villarim, Fabiola Traina, Talita Silveira, Monica Kopschitz Praxedes, Cristiana Solza, Leila Perobelli, Otavio Baiocchi, Rafael Gaiolla, Carla Boquimpani, Caroline Bonamin Sola, Roberta Oliveira de Paulae Silva, Ana Carolina Ribas, Kátia Pagnano, Giovanna Steffenello, Carmino de Souza, Nelson Spector, Angie Mae Rodday, Andrew M Evens, Susan K Parsons,
摘要
霍奇金淋巴瘤国际个体护理（整体）财团的A-IHIP模型于2022年开发用于先进的经典霍奇金淋巴瘤（CHL），可预测，在新诊断的患者中，在5年内生存。这项研究验证了其在巴西霍奇金淋巴瘤注册表中的表现。到2022年，巴西HL注册表包括1357名CHL患者，中位为5年随访。使用A-Hipi-Model方程计算了5年无进展生存期（PFS）和总生存期（OS）的概率。歧视（Harrell C统计/UNO C统计）和校准措施评估了外部验证和校准。排除了允许范围之外的实验值，反映了初始的A-IHIP分析。共有694名高级CHL患者符合原始纳入标准（年龄18-65岁，IIB-IV期）。中位年龄为31岁；女性为46.3％。阶段分布为IIB（33.1％），III（27.4％），IV（39.5％）。 32.6％的笨重疾病。 PFS和OS分别为68.4％和86.0％。 PFS的Harrell C统计量为0.60，OS为0.69，PFS的UNO C统计量为0.63，OS为0.72。 5年OS和PFS的校准斜率分别为0.91和1.03，校准图表现出了良好的预测。尽管患者不同，临床特征和社会经济因素，但基线预测工具在巴西队列中表现良好，证明了充分的歧视和校准。这支持其在不同环境中的可靠性。
Abstract
The Hodgkin lymphoma International Study for Individual Care (HoLISTIC) Consortium's A-HIPI model, developed in 2022 for advanced-stage classical Hodgkin lymphoma (cHL), predicts survival within 5 years amongst newly diagnosed patients. This study validates its performance in the Brazilian Hodgkin lymphoma registry. By 2022, the Brazilian HL registry included 1357 cHL patients, with a median 5-year follow-up. Probabilities for 5-year progression-free survival (PFS) and overall survival (OS) were calculated using A-HIPI-model equations. Discrimination (Harrell C-statistic/Uno C-statistic) and calibration measures assessed external validation and calibration. Lab values beyond the allowed range were excluded, mirroring the initial A-HIPI analysis. A total of 694 advanced-stage cHL patients met the original inclusion criteria (age 18-65 years, Stage IIB-IV). Median age was 31 years; 46.3% were females. Stage distribution was IIB (33.1%), III (27.4%), IV (39.5%). Bulky disease in 32.6%. Five-year PFS and OS were 68.4% and 86.0%, respectively. Harrell C-statistics were 0.60 for PFS and 0.69 for OS, and Uno C-statistics were 0.63 for PFS and 0.72 for OS. Calibration plots demonstrated well-calibrated predictions with calibration slopes of 0.91 and 1.03 for 5-year OS and PFS, respectively. Despite differing patient, clinical characteristics, and socioeconomic factors, the baseline prediction tool performed well in the Brazilian cohort, demonstrating adequate discrimination and calibration. This supports its reliability in diverse settings.