Immunobiologic prognostic factors in aggressive non-Hodgkin's lymphoma: The role of proliferative index, host-immune response, and continuous lactate dehydrogenase level in predicting survival in 148 consecutive subjects

grantor: University of TorontoThe prognostic value, with regard to survival, of proliferative index (% cells staining for Ki-67), host T-cell response (% cells staining for CD-4) in B-cell disease, and serum lactate dehydrogenase level (LDH, as a continuous variable), alone and in conjunction with the International Prognostic Index (IPI), was assessed in 148 consecutive subjects with aggressive (International Working Formulation subtypes F, G and H) non-Hodgkin's lymphoma (NHL). Cox proportional hazards regression demonstrated that continuous LDH was a useful prognostic factor in univariate analysis (relative risk of death 1.4, 'P' = 0.001), and modestly enhanced the prognostic value of the IPI on multivariate analysis (likelihood ratio test 'P' = 0.02). Neither Ki-67 nor CD-4 infiltrate provided prognostic information. Receiver operator characteristics (ROC) curve analysis demonstrated no better than poor to moderate discriminative ability in predicting death for the models generated. The reproducbility of the Ki-67 measure used was found to be questionable on reliability testing.M.Sc