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An individualized nomogram for predicting progression-free survival in systemic anaplastic large cell lymphoma: a multicenter, retrospective, and internally validated study.

Mei Zhou·Cui-Zhen Liu·Zhong-Qiong Wei·Sheng-Sheng Zhou·Kai-Teng Cai·Ji-Hao Zhou·Li-E Lin·Ting-Bo Liu·Wen-Yu Li·Hai-Yan Yang·Man Wang·Zhi-Gang Peng·Jie Ma
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Abstract

OBJECTIVES: To develop an individualized nomogram for predicting disease progression risk in systemic anaplastic large cell lymphoma (sALCL). METHODS: Independent predictors of progression-free survival (PFS) were identified using Cox regression in a multicenter retrospective cohort of 109 sALCL patients (2010-2022). These were incorporated into a three-factor nomogram, evaluated via bootstrapped internal validation (1000 resamples), ROC analysis, C-index, decision curve analysis (DCA), and clinical impact curve (CIC). RESULTS: A total of 29 PFS events occurred during a median follow-up of 31 months. Multivariable modelling selected serum β2-microglobulin elevation, extranodal disease, and front-line chemotherapy choice (CHOP versus CHOPE or BV+CHP) as autonomous progression drivers. Upon internal bootstrap validation, the nomogram yielded strong prognostic accuracy, achieving AUCs of 0.81, 0.85 and 0.87 for 1-, 3- and 5-year progression-free survival, alongside a corrected C-index of 0.779 (95% CI: 0.699 - 0.861). Calibration plots showed close agreement between predicted and observed outcomes, while DCA confirmed superior net clinical benefit versus conventional IPI or Ann Arbor stratification across multiple decision thresholds. CONCLUSION: This first sALCL-specific nomogram integrates clinical and treatment variables to provide personalized PFS risk estimation. While internally validated, this exploratory, observation-based tool requires external validation and recalibration in prospective cohorts before clinical implementation.

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HumansRetrospective StudiesFemaleNomogramsMaleProgression-Free SurvivalLymphoma, Large-Cell, AnaplasticMiddle AgedAgedPrognosisAdultSystemic anaplastic large cell lymphomadisease progressionfirst-line chemotherapynomogramprognostic modelprogression-free survivalrisk predictionβ-2 microglobulinJournal ArticleMulticenter Study

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Mei Zhou, Cui-Zhen Liu, Zhong-Qiong Wei, Sheng-Sheng Zhou, Kai-Teng Cai, Ji-Hao Zhou, Li-E Lin, Ting-Bo Liu, Wen-Yu Li, Hai-Yan Yang, Man Wang, Zhi-Gang Peng, Jie Ma. 2026-08-12. An individualized nomogram for predicting progression-free survival in systemic anaplastic large cell lymphoma: a multicenter, retrospective, and internally validated study.. https://doi.org/10.1080/16078454.2026.2715239

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Adult subjectAged subjectFemale subjectHumans subjectJournal Article subjectJournal Article; Multicenter Study resourceLymphoma, Large-Cell, Anaplastic subjectMale subjectMiddle Aged subjectMulticenter Study subjectNomogram subjectNomograms subjectdisease progression subjectfirst-line chemotherapy subject

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