Showing 16 results for Lymphoma
F Farnaghi, Z Safaee Naraghi, S Mohit,
Volume 56, Issue 1 (3-1998)
Abstract
Mycosis Fungoides (MF) is a cutaneous T-cell lymphoma (2,5). Alopecia is rarely seen in this disease, and the reported cases are in the form of follicular mucinosis (1,2,4). In this case report a patient is presented whose lesions all showed alopecia without mucinosis. Furthermore there was a patch of alopecia without any epidermal changes, which was clinicaly identical with alopecia areata, and histologically identical with MF. After six months of treatment there is regrowth of almost normal hair on all of the lesions
M Keihani ,
Volume 57, Issue 4 (7-1999)
Abstract
The purpose of this study was to find a more efficacious treatment for patients with primary central nervous system Lymphoma using chemotherapy. The objective was to determine the optimal time for radiotherapy treatment in relation to chemotherapy. Retrospective evaluation in patients with brain lymphoma was conducted from 1992 to 1998. Twenty-three patients were evaluated. Patients were divided into two groups based on the timing of radiotherapy in relation to the chemotherapy. The first group of patients (n=13) initially received radiotherapy followed by chemotherapy. Five of these patients receied classic CHOP (cyclophosphamide), Doxorubicine, Vincistine and Prednisone), six patients received Cis-platin (60 Megs/M2) and Etoposide (120 Megs/M2) and two patients received Cis-platin (60 Megs/M2), Etoposide (120 Megs/M2) and Cytarabine (600 Megs/M2) every 2 to 3 weeks. The second group of patients (Group II, n=10) received the followeing treatment regimen: a course of BCNU 120 Megs/M2 with Ifosfamide 1200 Megs/M2, Mesna and Etoposide 120 Megs/M2 on the first day of treatment (course A). Two weeks later, treatment was continued with a course of Cis-platin 35 Megs/M2 and Cytarabine 600 Megs/M2 (course B). The treatment was continued 14 days later with a course of Mitoxantron 12 Megs/M2, Ifosfamide 1200 Megs/M2 puls Mesna (course C). After the fourth week of chemotherapy, these patients received radiotherapy to the brain (5000 RADS in 4 weeks). During radiotherapy and at the beginning of course chemotherapy, intrathecal therapy with Methorexate 12 Megs/M2 and Cytarabine 60 Megs/M2 was given. Immediately after radiotherapy, the same chemothotrexate 12 Megs/M2 and Cytarabine 60 Megs/M2 was given. Immediately after radiotherapy, the same chemotherapy treatment was repeated to a total of 3 times. After complete clearance of the tumor determined by MRI and absence of tumor cells in the spinal fluid, the chemotherapeutic regimen was repeated one last time. The patients were evaluated for disease free survival and relaps based on the different treatment groups. Results: Median follow-up time was 19 months. Ten patients relapsed. These patients initially received radiotherapy (Group I). In this time period there were no relapses in Group II patients. The median DFS was 24 months with a chance of survival in 3 years of 45.95+11.95% for both groups. Chemotherapy followed by radiotherapy was more efficacious than radiotherapy prior to chemotherapy. Two years survival was 9% in contrast to 100% in favor of chemotherapy followed by radiotherapy. Conclusion: The above model demonstrated that treatment using a protocol consisting of chemotherapy prior to radiation provides improved disease free survival over a treatment regimen consisting of radiotherapy followed by chemotherapy.
Saljooghi N, Norouzi Z, Hashtroudizad H,
Volume 58, Issue 3 (6-2000)
Abstract
Non-Hodgkin's lymphoma is the 3rd most common cancers in children. In the present study, to determine pathological and clinical features of this cancer, we reviewed records of 84 cases of non-Hodgkin's lymphoma who were admitted to Ali Asghar and Bahrami children hospitals from 1989 to 1996. 59% of cases had small non-cleaved cell (SNCC) subtype of disease. 15% were lymphoblastic and 5% diffuse large cell subtype. The most prevalent primary sites were abdomen and lymph nodes. The most prevalent symptoms were abdominal mass (34%), abdominal pain (37%) and cervcal lymphadenopathy (26%). Over half of our patients were small non-cleaved cell subtype, and further studies should be done to find out reasons for this unusual finding.
Shahidi Sh, Seirafian Sh, Shayegan Nia B, Adilipoor H,
Volume 64, Issue 9 (9-2006)
Abstract
Background: Long term use of immunosuppressive therapy in transplant
recipients in order to prevent acute and chronic rejection increases the long
term risk of cancer. This study evaluates the incidence of different organs’
cancer after renal transplantation and immunosuppressive therapy.
Methods: This is a retrospective analysis of malignant tumors in renal graft
recipients with more than one year graft survival. Patients were assessed
according to their age, sex, diagnosis of cancer, immunosuppressive drugs,
donors and period of dialysis before transplantation.
Results: Evaluating all existing files in selected private clinics in Isfahan 350
patients were reviewed and 289 of them had entrance criteria. A total of 186
men and 103 women (mean age: 42.17±13.09 years) were included. They were
followed up over a mean period of 52.46±33.24 months. A total of six cases
(2.1%) of cancer were diagnosed in six recipients: All patients with cancer
were male with a mean age of 51.17±14.7 years (range: 26-68 years). Tumor
presented at a mean time of 51 months (rang: 15-82 months) after
transplantation. There were two patients with BCC, two patients with SCC and
two patients with lymphoma. Two patients died of progressive malignant
disease. Age, period of dialysis before transplantation, and using
immunosuppressive and anti-rejection drugs had no significant impact on
development of post transplant malignancy.
Conclusion: The frequency of tumors in these patients is lower than what
reported by other centers, probably due to short period of follow up and low
incidence of cancer in our general population. The risk of malignancy was 28
fold higher among transplant recipients than in general population. High risk
of cancer in this group, confirms the necessity of routine examination for
organ transplant recipients both before and after transplantation.
Oloomi Z, Moayeri H, Bahremand Sh, Vafaei P,
Volume 65, Issue 1 (3-2008)
Abstract
Background: Hyperuricemia is one of the oncologic emergency that occurs most often in patients with hematologic disorders particularly leukemia and high-grade lymphoma. This study was conducted in order to determine the prevalence of hyperuricemia with respect to prophylactic treatment (in particular allopurinol) in patients with lymphoproliferative disease in the pediatric hematologic ward of Imam Khomeini Hospital, Tehran.
Methods: In this retrospective cross-sectional study, 316 children (75 females, 241 males) under the age of 12 years participated. Among the subjects, 66 patients (20.9%) had lymphoma and 250 patients (79.1%) had leukemia.
Results: Of the 56 (17.7%) patients diagnosed with hyperuricemia, 13 with lymphoma (19.7%) and 43 (17.2%) with acute lymphoblastic leukemia, 52 patients showed hyperuricemia after induction of chemotherapy (p<0.001). Hyperuricemia was more prevalent in patients with more advanced disease (50.9% in stage IV, p<0.001). Hyperuricemia was more frequent in male patients (p<0.001). Among the 217 patients who had received prophylaxis (hydration, alkalization, allopurinol), 19 (8.7%) subjects had hyperuricemia compare to 37.3% in the group of patients who did not receive prophylactic treatment (p<0.001).
Conclusion: From the literature reviewed, a recombinant form of the urate oxidase enzyme (rasburicase) is a safe and effective alternative to allopurinol to rapidly control plasma uric acid concentrations in patients with hematologic malignancy at high risk for tumor lysis during induction of chemotherapy. In this respect, we recommend a prospective study to compare allopurinol and rasburicase in children with leukemia and lymphoma.
Esfahani A, Iravani M, Khoshnyat M, Ghoreishi Z, Shamshiri A R, Moghadam Z, Jahani M, Ghavamzadeh A,
Volume 65, Issue 5 (8-2007)
Abstract
Background: Bone marrow transplantation (BMT) is the treatment of choice for many patients with malignant and nonmalignant diseases. Long-term complications such as osteoporosis should be considered, because it is directly associated with the morbidity and mortality. The purpose of this study is to assess the bone mineral density after allogenic or autologous bone marrow transplantation in patients with leukemia or lymphoma.
Methods: We prospectively investigated 63 patients undergoing BMT for acute and chronic leukemia and lymphoma. At the end of the study, a total of 28 patients were assessed. Bone mineral density (BMD) was measured prior BMT, and 6 and 12 months after BMT. Osteocalcin, bone alkaline phosphatase and C-terminal telopeptides of type 1 collagen (ICTP) were assessed. Serum concentration of calcium, phosphorous, vitamin D, PTH and sex hormones (FSH, LH, testosterone and estradiol) were also measured.
Results: There was a significant decrease in the bone mineral density of the femoral neck six months after BMT (p<0.001), 1.01±0.13g/cm² prior to BMT and 0.96±0.13 g/cm² at six months, but no considerable changes were seen in lumbar vertebrae. Bone loss between the 6th and 12th months was not observed. The levels of ICTP and phosphorus increased significantly by the 12th month (p=0.04). The level of calcium was higher at the 6th month (p=0.002) but the level of vitamin D and PTH decreased by the end of the study (p=0.04 and p=0.01, respectively) and the average of osteocalcin did not increase significantly. In women, the level of estradiol decreased by the 6th month (p=0.01), but the testosterone changes were not significant.
Conclusion: The risk of bone loss in both allogeneic and autologous BMT is higher in the femoral neck than the lumbar vertebrae, occurring mainly in the first six months after BMT. Preventive and clinical procedures should be considered.
Sadighi S, Tirgary F, Raafat J, Mohagheghi Ma, Safavi S, Vaziri S,
Volume 67, Issue 8 (11-2009)
Abstract
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Background: Diffuse large B Cell lymphoma (DLBCL)
is the most common subtype of non-Hogkin lymphoma (NHL).
We performed a retrospective study of patients with de novo DLBCL
treated in the Medical Oncology department of Cancer Institute of Iran, Tehran
to assess the clinicopathologic and immunohistochemistry correlation and
prognosis of the patients.
Methods: World Health Organization
(WHO) classification was used to reexamine 1470
biopsy specimens related to the years 1985-2006.
After excluding five cases of T Cell
large cell lymphoma, 50 Patients diagnosed as
DLBCL.
Results: Median age of the patients was 45.5(20-85)
years: 60% were male and 30%
had primary extranodal disease. The most common extranodal sites were bone,
gastrointestinal tract and Head and neck areas. The most common stages were
stage II (32%), stage III (32%),
stage IV (20%) and stage I
(16%) retrospectively and 33% had B-symptoms.
All of The Patients received chemotherapy (83% CHOP regimen)
and 46% treated by radiotherapy after chemotherapy. With
a mean follow up time of 32 months, median
survival time was 34 (95% CI 24-40) months.
Prognostic factors for survival were tumor stage, B-symptoms
and early relapse (less than 6 months).
Conclusions: Our data showed the importance of Immunohistochemistry method in diagnosis of DLBCL.
Although DLBCL is potentially curable
with CHOP chemotherapy protocol, addition of monoclonal
antibody (Anti CD20) and finding new
prognostic factors to predict early relapse are clearly needed in Iran.
Pourakbari B, Mamishi S, Pajand O, Nadji Sar, Mahjob F, Kochakzadeh L, Izadyar M, Parvaneh N, Saboni F,
Volume 67, Issue 11 (2-2010)
Abstract
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Background: Latent Epstein- Barr
virus (EBV) genomes are found in the malignant cells of
approximately one-third of Hodgkin's lymphoma (HL) cases. Detection of EBV viral DNA could potentially be used as a biomarker of disease activity. Our goal was
to compare of EBV DNA detection in samples obtained from lymphoma
patients versus controls.
Methods: One milliliter uncoagulated and 1ml coagulated blood sample for DNA extraction and serum analysis using ELISA for IgG anti EBNA-1 were obtained from 44 lymphoma patients and from 44 normal controls,
respectively. EBV genome, EBNA-2, was examined from DNA extracts of paraffin
embedded and blood samples using Nested PCR with type specific inner primers.
Results: Positive results for ELISA, Blood and biopsy PCR in study group were, 84.1%, 27.3% and 13.6%, respectively. However, these results in
control group were 47.7% and 16% for ELISA and Blood PCR assays, respectively. Positive results in ELISA, Blood PCR and Biopsy PCR in Hodgkin and non-Hodgkin patients were found in 21(84%), 6(24%), 4(16%) and 16(84.2%), 6(31.6%), 2(10.5%) of specimens, respectively. No significant
differences in EBV detection were found between these two
patient groups (p values for ELISA, Blood PCR and Biopsy PCR were 0.26, 0.73 and 0.68, respectively).
Conclusion: Comparison of ELISA and Blood PCR results in children and adult
patients with the same age of controls have showed difference in ELISA results of children, only.
None of the test results have showed statistically significant difference
between Hodgkin and non-Hodgkin patients. However, the mean of ELISA results in Hodgkin patients
was higher as compared with controls. Blood PCR assay cannot be recommended as a biomarker of disease activity in EBV positive Hodgkin's lymphoma
patients.
Kosari F, Yarigarravesh Hr, Rezvan M,
Volume 70, Issue 6 (9-2012)
Abstract
Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma. There are various types of DLBCL including immunoblastic and centroblastic. Epstein-Barr virus (EBV) is a member of Herpes virus family found in all human populations inducing different lymphoproliferative disorders. The role of EBV in the development of DLBCL is known. Multiple laboratory methods are available for detecting EBV. This study was conducted to determine the correlation of EBV with DLBCL in samples referred to pathology ward in Shariati and Sina Hospitals by chromogenic in situ hybridization (CISH) method.
Methods: In this case/control study, pathological specimens of 50 patients with DLBCL as well as 50 reactive lymph nodes and tonsils (control group) were collected from archives of Shariati and Sina Hospitals and were evaluated for EBV encoded RNA (EBER) expression based on CISH method. A peptide nucleic acid (PNA) EBV probe (Dakocytomatin) was used while all the processes were done in RNAase-free conditions using RNAase-free water, sterile gloves and samplers.
Results: Out of fifty specimens in the case group, eight were positive for EBER in comparison with two in the control group (P=0.046). No statistically significant difference was observed between intranodal or extranodal samples (P=0.736) or between males and females (P=0.0746).
Conclusion: Our study showed that EBV positivity for EBER in patient with DLBCL could be determined more effectively by CISH method than immunohistochemistry (IHC). Comparative analysis between CISH, PCR and IHC methods is recommended.
Kamiab Hesari K, Gheiasi M, Niko A, Biglarian M, Seyyed Gamali M,
Volume 70, Issue 10 (1-2013)
Abstract
Background: Primary cutaneous lymphoma is separated into two groups, cutaneous lymphoma (CTCL) and cutaneous B-CELL Lymphoma (CBCL). This study was performed to classify histopathologically and define demographic features of Persian patients with primary cutaneous lymphoma.
Methods: Twenty hundred and thirty four patients with primary cutaneous lymphoma who have been referred to Razi Hospital in Tehran, Iran during at four year period (October 2005 to October 2009), were investigated in this study. The data were gathered by reviewing their medical records andexaminedagain extant evidence andhistology slides.
Results: Among 234 Patients, the only clinical feature that could be assessed was itching. The most common involves location of disease was generalized. 189 (80.77%) cases of the patients had CTCL and 45 (19.23%) cases of the patients had CBCL. Age of patients with two lymphoma type were similar at the this time of diagnosis. Sex supremacy was with men in two groups.
Conclusion: This study provides histopathologic classification and demographic data.
Noorian Se, Beigi Aa, Safaee M, Heshmat-Ghahdarijani K,
Volume 70, Issue 10 (1-2013)
Abstract
Background: Primary pancreatic lymphoma is really rare and comprising about 0.2-4.9% of all pancreatic malignancies. The diagnosis of this lymphoma is very difficult because the clinical symptoms and signs resemble those of pancreatic adenocarcinoma.
Case presentation: A 30-year old man was admitted to the hospital with the complaint of left upper abdominal pain. Because of his splenomegaly and pancytopenia he was candidate for splenectomy but during operation a large mass was found in the pancreas and biopsy was taken from it. Pathology reported lymphoblastic lymphoma of pancreas.
Conclusion: It is important to differentiate between primary lymphoma and the adenocarcinoma of the pancreas as prognosis and treatment of them differ significantly. Primary pancreatic lymphoma should be considered in differential diagnosis of pancreatic tumors and an attempt to obtain tissue diagnosis is always necessary before radical surgery, especially in young patients.
Ali Ghasemi , Abdollah Banihashem , Nosrat Ghaemi , Saghi Elmi , Habibollah Esmaeili , Reza Erfani Sayyar, Sam Elmi ,
Volume 72, Issue 1 (4-2014)
Abstract
Background: In most children with Acute Lymphoblastic Leukemia (ALL) and Non Hodgkin’s Lymphoma (NHL) who have received chemotherapy with and without radi-otherapy, some late effects due to treatment may occur such as endocrinopathies.
Methods: We evaluated growth criteria (including short stature, obesity) and thyroid test function in 50 children with ALL (n= 25) and NHL (n= 25) 3-17 year-old in remis-sion period who randomly received chemotherapy with (n= 25) or without (n= 25) radi-ation such as our treatment groups. The values for height, weight and BMI in less than 5th or more than 95 th percentile considers abnormal.
Results: Six (12%) patients were in less than 5th percentile height (short stature). Two patients (4.0%) had over-weight and 48 (96%) were in normal range of BMI. Six (12%) patients were in less than 5th and 3 (6%) were in more than 95 th weight percentile. There was no significant difference between two different treatment groups for TSH (P= 0.662 (but there was a significant difference between these groups in case of T4 (P= 0.049(. Mean and SD for T4 in patients with chemotherapy alone was less than in whom received chemotherapy plus radiotherapy. There was no significant difference between ALL and NHL groups for TSH, T4 (P= 0.567, 0.528 respectively). Two boys with ALL without history of radiation had hypothyroidism that had based on their la-boratory data.
Conclusion: Regarding to effects of thyroid dysfunction on short stature and obesity in adolescent with ALL and NHL, we suggest to have more attention about growth, thy-roid test to avoid late side effect of malignancy treatment.
Malihe Hassanzadeh , Amir Hosein Jafarian , Fatemeh Homaee, Lida Jeddi , Parnian Malakuti, Leila Mousavi Seresht ,
Volume 78, Issue 1 (4-2020)
Abstract
Background: Although cervical malignancy rate had grown up in recent years, primary cervical lymphoma is so rare. It must be high index of suspicious for primary cervical lymphoma diagnosis in patient with malignancy-like signs and symptoms for early detection. Primary cervical lymphoma has no standard treatment or follow-up protocol; so the management still is in doubt and based on previous case reports. In the other hand, the precise prognosis of patient is undetermined. In the present study, a case of primary cervical lymphoma is presented which was misdiagnosed at first. The patient accurate diagnosis was made at last due to multidisciplinary team working.
Case presentation: A 51-year-old woman, gravida 2, para 2, presented with complaint of abnormal vaginal bleeding and discharge, with no abnormal finding in cervical cytology and sonography, so uneventfully a diagnostic error had happened in the assessment of her. After several months and multiple different treatment, the patient referred to the Oncology Department of Obstetrics and Gynecology Center, Ghaem Hospital, Mashhad, Iran in May 2017. Re-assessment was performed by biopsy and imaging, and the final pathologic diagnosis of diffuse large B-cell non-Hodgkin's lymphomas was confirmed.
Conclusion: Primary cervical lymphoma is an uncommon malignancy; the diagnosis could be missed simply by low suspicious due to low accuracy of Pap smear and imaging in this situation. So an accurate evaluation and pelvic examination, high suspicious and close communication between clinician and pathologist are needed. By timely diagnosis of patient in early stage and appropriate approach, the prognosis could be excellent most of the time.
Ali Hadi , Valiollah Mehrzad , Nazanin Vaziri , Lalaeh Shariati , Golnaz Vaseghi ,
Volume 78, Issue 2 (5-2020)
Abstract
Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma (NHL), which is the most common type of lymphoma. NHL comprises a group of clinically and biologically diverse diseases, which range from indolent to aggressive clinical courses. Despite treatment advances in the last three decades with the use of combination immunotherapy, a significant fraction of patients relapses or are refractory to these treatments. Actually, there is no standard method for detection of recurrence. The purpose of this study was to evaluate the level of this enzyme in the patients with recurrent DLBCL compared to healthy controls.
Methods: In this randomized double-blind, placebo-controlled trial, the serum level of pyruvate dehydrogenase (PDH) enzyme in total of 26 patients with DLBCL recurrence in compare with 26 healthy individuals in the Sayed Al-Shohada Hospital, Isfahan University of Medical Sciences in Iran from September 2016 to September 2018, were assessed. The clinical data including age criteria, the Eastern Cooperative Oncology Group (ECOG) score rating, total bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time and international normalized ratio (PT/INR), CT-scan, serum creatinine, platelet count, the absolute number of neutrophils, and the interval until the last treatment were gathered. After obtaining informed consent, blood samples were taken. and the PDH enzyme was measured in case and control groups.
Results: Fifty-three percent of patients were male and the mean age of participants in case and control groups was 37.2±17.3 and 34.8±8.9, respectively. Subsequently, the PDH levels were measured according to the enzyme protocol. The levels of enzyme in patients with relapse were significantly lower than normal ones (P=0.0003). The PDH serum level was also evaluated by age and sex, which did not show any significant differences (P=0.86).
Conclusion: In patients with relapsing B-cell lymphoma, the pyruvate dehydrogenase (PDH) enzyme serum levels were significantly lower than healthy subjects, but this difference was not related to age and gender. In the case of further studies and comparisons beyond this study, this enzyme could be a good candidate, used as an alternative diagnosis tool, in patients with recurrent lymphoma.
Zohreh Dalirsani, Atessa Pakfetrat, Nasrollah Saghravanian, Negin Samiee, Samaneh Salari ,
Volume 79, Issue 1 (4-2021)
Abstract
Background: Lymphoma is a malignant proliferation of lymphoid cells. External T-cell lymphoma is very rare. Lymphomas are neoplastic growth of lymphocytes caused by organisms like EBV, HIV, etc. This malignancy is classified as Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Oral lymphomas account for a small percentage of head and neck malignancies, and intraoral lymphoma is rare and mostly seen in Waldeyer's ring of immunocompromised patients.
Case presentation: A 67-year-old female was referred with a palatal wound that developed within two months. In medical history, she had a peptic ulcer since last year, and intestine lymphoma was diagnosed 4 months later. After that, her gastrointestinal lymphoma was treated with surgery and chemotherapy for 6 sessions. The oral examination revealed an endophytic ulcer with a granular surface in the left posterior part of the hard and soft palate and maxillary alveolar ridge. The lesion was under biopsy with clinical differential diagnosis of squamous cell carcinoma or metastatic lymphoma or deep fungal infection. Microscopic examination with hematoxylin and eosin (H&E) staining revealed malignant mononucleated lymphocytes and hyperchromatic, polymorphic, dysplastic cells. Also, acinic cells and muscular cells were destructed. Moreover, immunohistochemistry (IHC) analysis was positive for CD3, showing the presence of T lymphocytes. Therefore, diagnosis of metastasis of intestinal T-cell lymphoma to oral cavity was established. Because the patient had a history of intestinal lymphoma, she was referred to the oncologist for treatment. In further examinations, lung and liver metastasis were detected and the patient died on the second session of chemotherapy.
Conclusion: Malignant metastases to the oral cavity can occur in various forms, including swelling and ulcer, periodontal lesion and tooth luxation. Since, metastatic lesions in the oral cavity, could imitate the feature of inflammatory lesions, a thorough examination and taking history can be helpful in the early diagnosis and appropriate treatment planning to increase patients’ survival.
Zeinab Asakereh, Elham Maraghi, Bijan Keikhaei, Amal Saki Malehi ,
Volume 80, Issue 7 (10-2022)
Abstract
Background: In many studies, Cox regression was used to assess the important factors that affect the survival of cancer patients based on demographic and clinical variables. The aim of this study was to determine the factors affecting the survival of patients with Hodgkin's lymphoma using the random survival forest (RSF) method and compare it with the Cox model.
Methods: In this retrospective cohort study, all patients with Hodgkin's lymphoma who were referred to the Oncology and Hematology Center of Ahvaz Shafa Hospital from March 2000 to February 2010 were included. The survival time was calculated from diagnosis to the first recurrence event date (based on month). To assess the process of the disease, demographic characteristics and disease-related variables (including disease stage, chemotherapy, site of lymph involvement, etc.) were extracted from the records of 387 patients with Hodgkin's lymphoma. To investigate the prognostic factors that affect the recurrence of disease the Cox model and RSF were implemented. Moreover, their performance based on the C-index, IBS, and predictor error rate of the two models were compared Data analysis was implemented by using R4.0.3 software (survival and RandomForestSRC packages).
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Results: The results of the Cox model showed that LDH (P=0.001) and classical lymphoma classification (P<0.001) were associated with an increased risk of relapse in patients. However, the results of the RSF model showed that the important variables affecting the recurrence of disease were the stage of disease, chemotherapy, classical lymphoma classification, and hemoglobin, respectively. Also, the RSF model showed a higher (c-index=84.9) than the Cox model (c-index=57.6). Furthermore, the RSF model revealed a lower error rate predictor (0.09) and IBS index (0.175) than the Cox model. So, RSF has performed better than the Cox model in determining prognostic factors based on the suitability indicators of the model.
Conclusion: The RSF has high accuracy than the Cox model when there is a high number of predictors and there is collinearity. It can also identify the important variables that affect the patient's survival.
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