Evaluation of three prognostic indexes in follicular lymphoma
Bibliographic record
Abstract
6595 Background: Three validated prognostic models have been proposed for use in patients with follicular lymphoma (FL), the International Non-Hodgkin’s Lymphoma Prognostic Index (IPI), the ILI model from the Italian intergroup, and recently the FLIPI model from the French International Lymphoma Prognostic Index. The aim of this study was to apply these three models to a group of FL patients to determine the concordance between them and their usefulness in predicting clinical outcome, including rate of transformation. Methods: The IPI index (age >60 years, extranodal involvement ≥2 sites, elevated lactate dehydrogenase (LDH), ECOG performance status ≥2, stage ≥3), the ILI index (age >60, extranodal involvement ≥ 2 sites, elevated LDH, male sex, B symptoms and erythrocyte sedimentation rate ≥ 30) and the FLIPI index (age > 60, stage ≥ 3, elevated LDH, number of nodal sites > 4, hemoglobin < 120 g/L), respectively were calculated and applied to 100 patients diagnosed with FL (grade I-III) between 1994 and 2001. Overall survival (OS) and progression free survival (PFS) were calculated for each prognostic group (low, intermediate and high risk) by the Kaplan-Meier method. Results: The median follow-up of our series was 31 months (mo) (range 1–340). Median OS was 24 mo (range 1–226). The median PFS was 41 mo (range 4–145). Concordance between the three indexes was 40%. The index that best predicted mortality was the ILI (p=0.027). The distribution of patients and mean overall survival according to risk group were similar for each index. Patients who went on to transform to aggressive NHL were rarely classified as high risk at diagnosis of FL by any index. Conclusions: Although the concordance between the three models was low, each is useful for classifying FL patients into risk groups and in predicting outcome in this group of patients. Transformation was not well predicted by any of the models. This information will be combined with cytogenetic, immunohistochemical, and DNA microarray data from frozen tumor tissue (currently proceeding) to develop a combined molecular and clinical prognostic index. A combined index may help select appropriate treatment for individual patients. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".