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A risk stratification model for nodal peripheral T-cell lymphomas based on the NCCN-IPI and posttreatment Deauville score

  • Ho-Young Yhim
  • Yong Park
  • Yeon-Hee Han
  • Sungeun Kim
  • Sae-Ryung Kang
  • Joon-Ho Moon
  • Ju Hye Jeong
  • Ho-Jin Shin
  • Keunyoung Kim
  • Yoon Seok Choi
  • Kunho Kim
  • Min Kyoung Kim
  • Eunjung Kong
  • Dae Sik Kim
  • Jae Seon Eo
  • Ji Hyun Lee
  • Do-Young Kang
  • Won Sik Lee
  • Seok Mo Lee
  • Young Rok Do
  • Jun Soo Ham
  • Seok Jin Kim
  • Won Seog Kim
  • Joon Young Choi
  • Deok-Hwan Yang
  • Jae-Yong Kwak
Original Article

Abstract

Purpose

The aim of this study was to establish a risk-stratification model integrating posttreatment metabolic response using the Deauville score and the pretreatment National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) in nodal PTCLs.

Methods

We retrospectively analysed 326 patients with newly diagnosed nodal PTCLs between January 2005 and June 2016 and both baseline and posttreatment PET/CT data. The final model was validated using an independent prospective cohort of 79 patients.

Results

Posttreatment Deauville score (1/2, 3, and 4/5) and the NCCN-IPI (low, low-intermediate, high-intermediate, and high) were independently associated with progression-free survival: for the Deauville score, the hazard ratios (HRs) were 1.00 vs. 2.16 (95% CI 1.47–3.18) vs. 7.86 (5.66–10.92), P < 0.001; and for the NCCN-IPI, the HRs were 1.00 vs. 2.31 (95% CI 1.20–4.41) vs. 4.42 (2.36–8.26) vs. 7.09 (3.57–14.06), P < 0.001. Based on these results, we developed a simplified three-group risk model comprising a low-risk group (low or low-intermediate NCCN-IPI with a posttreatment Deauville score of 1 or 2, or low NCCN-IPI with a Deauville score of 3), a high-risk group (high or high-intermediate NCCN-IPI with a Deauville score of 1/2 or 3, or low-intermediate NCCN-IPI with a Deauville score of 3), and a treatment failure group (Deauville score 4 or 5). This model was significantly associated with progression-free survival (5-year, 70.3%, 31.4%, and 4.7%; P < 0.001) and overall survival (5-year, 82.1%, 45.5%, and 14.7%; P < 0.001). Similar associations were also observed in the independent validation cohort.

Conclusion

The risk-stratification model integrating posttreatment Deauville score and pretreatment NCCN-IPI is a powerful tool for predicting treatment failure in patients with nodal PTCLs.

Keywords

Peripheral T-cell lymphoma PET/CT International prognostic index Prognosis Treatment 

Notes

Acknowledgments

We acknowledge the support of the Biomedical Research Institute, Chonbuk National University Hospital.

Funding

This study was supported by funding from the Biomedical Research Institute, Chonbuk National University Hospital.

Compliance with ethical standards

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

This study protocol was approved by the institutional review board (IRB) of each participating institution. Because this study was a retrospective analysis involving no more than minimal risk to the subjects, the IRB granted a waiver of written informed consent.

Supplementary material

259_2018_4093_MOESM1_ESM.docx (342 kb)
ESM 1 (DOCX 341 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018
corrected publication September/2018

Authors and Affiliations

  • Ho-Young Yhim
    • 1
    • 2
  • Yong Park
    • 3
  • Yeon-Hee Han
    • 4
  • Sungeun Kim
    • 5
  • Sae-Ryung Kang
    • 6
  • Joon-Ho Moon
    • 7
  • Ju Hye Jeong
    • 8
  • Ho-Jin Shin
    • 9
  • Keunyoung Kim
    • 10
  • Yoon Seok Choi
    • 11
  • Kunho Kim
    • 12
  • Min Kyoung Kim
    • 13
  • Eunjung Kong
    • 14
  • Dae Sik Kim
    • 15
  • Jae Seon Eo
    • 16
  • Ji Hyun Lee
    • 17
  • Do-Young Kang
    • 18
  • Won Sik Lee
    • 19
  • Seok Mo Lee
    • 20
  • Young Rok Do
    • 21
  • Jun Soo Ham
    • 22
  • Seok Jin Kim
    • 22
  • Won Seog Kim
    • 22
  • Joon Young Choi
    • 23
  • Deok-Hwan Yang
    • 24
  • Jae-Yong Kwak
    • 1
    • 2
  1. 1.Department of Internal MedicineChonbuk National University Medical SchoolJeonjuSouth Korea
  2. 2.Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University HospitalJeonjuSouth Korea
  3. 3.Department of Internal MedicineKorea University Anam Hospital College of MedicineSeoulSouth Korea
  4. 4.Department of Nuclear MedicineChonbuk National University HospitalJeonjuSouth Korea
  5. 5.Department of Nuclear MedicineKorea University Anam HospitalSeoulSouth Korea
  6. 6.Department of Nuclear MedicineChonnam National University Hwasun HospitalJeollanam-doSouth Korea
  7. 7.Department of Internal MedicineKyungpook National University HospitalDaeguSouth Korea
  8. 8.Department of Nuclear MedicineKyungpook National University HospitalDaeguSouth Korea
  9. 9.Department of Internal MedicinePusan National University HospitalBusanSouth Korea
  10. 10.Department of Nuclear Medicine and Biomedical Research InstitutePusan National University HospitalBusanSouth Korea
  11. 11.Department of Internal MedicineChungnam National University HospitalDaejeonSouth Korea
  12. 12.Department of Nuclear MedicineChungnam National University HospitalDaejeonSouth Korea
  13. 13.Department of Internal MedicineYeungnam University College of MedicineDaeguSouth Korea
  14. 14.Department of Nuclear MedicineYeungnam University College of MedicineDaeguSouth Korea
  15. 15.Department of Internal MedicineKorea University Guro Hospital College of MedicineSeoulSouth Korea
  16. 16.Department of Nuclear MedicineKorea University Guro Hospital College of MedicineSeoulSouth Korea
  17. 17.Department of Internal MedicineDong-A University College of MedicineBusanSouth Korea
  18. 18.Department of Nuclear MedicineDong-A University College of MedicineBusanSouth Korea
  19. 19.Department of Internal MedicineInje University College of Medicine, Inje University Busan Paik HospitalBusanSouth Korea
  20. 20.Department of Nuclear Medicine, Inje University College of MedicineInje University Busan Paik HospitalBusanSouth Korea
  21. 21.Department of Internal Medicine, Dongsan Medical CenterKeimyung University School of MedicineDaeguSouth Korea
  22. 22.Department of MedicineSungkyunkwan University School of MedicineSeoulSouth Korea
  23. 23.Department of Nuclear Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  24. 24.Department of Internal MedicineChonnam National University Hwasun HospitalJeollanam-doRepublic of Korea

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