Charlson Comorbidity Index (CCI) in Diffuse Large B-cell Lymphoma: A New Approach in a Multicenter Study

Rafet Eren; Istemi Serin; Suheyla Atak; Betul Zehra Pirdal; Nihan Nizam; Aliihsan Gemici; Demet Aydın; Naciye Demirel; Esma Evrim Dogan; Osman Yokus

doi:10.1007/s12288-022-01567-5

Charlson Comorbidity Index (CCI) in Diffuse Large B-cell Lymphoma: A New Approach in a Multicenter Study

Indian J Hematol Blood Transfus. 2023 Apr;39(2):191-199. doi: 10.1007/s12288-022-01567-5. Epub 2022 Sep 28.

Authors

Affiliations

¹ Department of Hematology, Istinye University, Liv Hospital, Istanbul, Turkey.
² Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Org.Nafiz GURMAN Cad, 34098 Istanbul, Fatih, Istanbul Turkey.
³ Department of Internal Medicine, University of Health Sciences, Prof.Dr. Cemil Tascioglu Training and Research Hospital, Istanbul, Turkey.
⁴ Medical Faculty of Cerrahpasa, Department of Public Health, Istanbul University- Cerrahpasa, Istanbul, Turkey.
⁵ Department of Internal Medicine, Çigli Training and Research Hospital, Izmir, Turkey.
⁶ Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey.
⁷ Department of Hematology, University of Health Sciences, Prof.Dr. Cemil Tascioglu Training and Research Hospital, Istanbul, Turkey.

Abstract

Purpose: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of adult lymphomas. The incidence of DLBCL increases with age and has a fairly rapid fatal course without treatment. Patients often have difficulty tolerating standard chemotherapy regimens due to their comorbidities. Charlson Comorbidity Index (CCI), which is calculated by considering 19 different comorbidities, was developed in 1987 and is widely used for mortality prediction in cancer patients. Literature data on CCI and hematological malignancies are limited. Main aim in this study is to evaluate the effectiveness of CCI and compare to the International Prognostic Index (IPI) scoring system in the DLBCL patient group.

Methods: A total of 170 patients diagnosed with DLBCL between 1.1.2002- 1.12.2020 were included in the study. Statistical analyzes were performed among patients whose IPI and CCI scores were recorded by considering baseline data.

Results: The median age of patients was 58 (range: 17-84). Thirty-five (20.6%) patients had stage III and 76 (44.7%) had stage IV disease. When the CCI, IPI and ECOG scores were compared with the mortality status of the patients as a reference, AUCs were resulted as 0.628 (95% CI: 0.506-0.749), 0.563 (95% CI: 0.484-0.639) and 0.672 (95% CI: 0.596-0.743), respectively. There was no significant difference between the ROC curves of CCI, IPI and ECOG scores. Patients with a CCI score of ≥ 4 had shorter OS comperad to those with a score of < 4.

Conclusion: Rather than claiming that CCI is superior to IPI, ECOG or another scoring system in a single-center patient population, it should be stated that CCI is also an effective scoring system in patients diagnosed with DLBCL.

Supplementary information: The online version contains supplementary material available at 10.1007/s12288-022-01567-5.

Keywords: Charlson Comorbidity Index; Diffuse large B-cell lymphoma; efficacy; prognosis.

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