Comparative analysis of international prognostic indices in gray-zone lymphoma

Abstract

Gray-zone lymphoma (GZL) reflects an aggressive B-cell neoplasm with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin lymphoma (cHL). The International Prognostic Index (IPI) and its derivatives (R-IPI, NCCN-IPI, and the Hasenclever IPS) have been established for DLBCL or cHL while the most suitable scoring system for GZL remains undetermined. In an exploratory multi-centric cohort of GZL (n = 61), we performed a comparative analysis of prognostic indices with regard to model fit and mutual concordance. The calculation of the corrected Akaike’s information criterion (cAIC) and Harrel’s concordance index (c-index) for each scoring system identified the NCCN-IPI to harbor the most convincing prognostic capabilities regarding both overall survival (OS) and progression-free survival (PFS) compared to its enhanced derivatives. The current results affirm the clinical utility of the NCCN-IPI and suggest its preferential use in clinical practice in GZL-patients.

Keywords:

• Gray-zone lymphoma
• risk stratification
• IPI
• prognosis

Disclosure statement

The authors declare no conflicts of interest.

Author contributions

N.G. and H.M.W.: study concept. V.B., A.B., H.M.W., N.G., H.W.B., and H.M.: data collection. H.M.W., N.G., A.C.F., and V.B.: data analysis and creation of figures and tables. H.M.W. and N.G.: initial draft of the manuscript. All authors: critical revision and approval of the final version.