Scrutinizing prognostic scores’ effectiveness in non-Hodgkin’s lymphomas with primary lymph node involvement

Abstract

Introduction. Non-Hodgkin lymphoma (NHL) encompasses a diverse group of malignancies arising from malignant proliferation of lymphocytes, each subtype characterized by unique epidemiological, etiological, and clinical features. Prognostication is essential for guiding treatment decisions and improving patient outcomes. Prognostic scores, including traditional and molecular systems, offer insights into survival prediction. The aim of the present study was to evaluate the applicability of traditional prognostic scores based on clinical markers and laboratory biomarkers in predicting the outcomes of patients with primary nodal NHL. Materials and methods. This study included 78 NHL patients treated at the Chisinau Oncological Institute from 2017 to 2021. Clinical and biological data were collected, and the following prognostic scores were calculated: International Prognostic Index (IPI), The combined index of hemoglobin, albumin, lymphocyte, and platelet (HALP score), Platelet to Lymphocyte Ratio (PLR), Neutrophil to Lymphocyte Ratio (NLR), Albumin/Globulin ratio (AG), and Charlson comorbidity index (CCI). Statistical analyses, including descriptive statistics, ROC curve analysis, and Kaplan-Meier survival curves, were conducted. Results. Of the patients, 40 (51.2%) were female, with a mean age of 57.1 ± 10.2 years. Peripheral lymph nodes were predominantly affected (84.6%), with diffuse large B-cell lymphoma being the most prevalent subtype (59.0%). Prognostic scores, including the International Prognostic Index (IPI), Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, and Charlson Comorbidity Index (CCI), demonstrated varying levels of discriminatory ability in predicting overall survival (OS). Notably, the HALP score (AUC = 0.650; p = 0.026), IPI (AUC = 0.745; p = 0.0002), and CCI (AUC = 0.636; p = 0.043) were statistically significant predictors of OS. Conclusions. Traditional prognostic scores (IPI. HALP score, CCI) offer valuable prognostic information for NHL patients. Further research is needed to validate these findings and explore cost-effective prognostic strategies.