HoLISTIC联盟的晚期霍奇金淋巴瘤国际预后指数（A-HIPI）在巴西霍奇金淋巴瘤登记中的外部验证与校准

External validation and calibration of the HoLISTIC Consortium's advanced-stage Hodgkin lymphoma international prognostic index (A-HIPI) in the Brazilian Hodgkin lymphoma registry

BRITISH JOURNAL OF HAEMATOLOGY

影响因子:3.8

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,

DOI: 10.1111/bjh.19824

摘要

霍奇金淋巴瘤国际研究对个体护理（HoLISTIC）联盟于2022年开发的A-HIPI模型，旨在预测新诊断晚期经典霍奇金淋巴瘤（cHL）患者的5年生存率。此次研究验证了其在巴西霍奇金淋巴瘤登记中的表现。到2022年，巴西HL登记包括1357例cHL患者，随访中位数为5年。利用A-HIPI模型方程计算了患者的5年无进展生存（PFS）和总生存（OS）概率。采用Harrell C统计量和Uno C统计量评估模型的判别能力和校准情况。排除超出允许范围的实验室指标，复现了最初的A-HIPI分析。符合原始入组标准的晚期cHL患者共694例（年龄18-65岁，IIB-IV期），其中中位年龄为31岁，女性占46.3%。分期分布为IIB（33.1%）、III（27.4%）和IV（39.5%），大块病变占32.6%。五年PFS和OS分别为68.4%和86.0%。Harrell C统计量为PFS 0.60，OS 0.69，Uno C统计量为PFS 0.63，OS 0.72。校准图显示预测效果良好，5年OS和PFS的校准斜率分别为0.91和1.03。尽管患者特征、临床参数及社会经济因素存在差异，但该基础预测工具在巴西队列中表现良好，具有良好的判别和校准能力，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.