Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i3.5557
Abstract
Primary lymphoma of bone (PLB) has a substantially poorer prognosis when distant organ involvement is present, making early risk identification clinically important. We used SEER data to develop and validate machine-learning models for predicting distant organ involvement in PLB and applied SHAP to interpret key predictors. A web-based calculator was built from the best-performing model. Among 690 analyzed patients, the Random Forest (RF) model showed the best performance, with an internal-validation accuracy of 0.852 and AUC of 0.907. This RF-based model may support individualized risk assessment and clinical decision-making in PLB.
Keywords
primary lymphoma of bone, metastasis, SEER, machine learning, prediction model
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[42] Glotzbecker MP, Kersun LS, Choi JK, Wills BP, Schaffer AA, Dormans JP. Primary non-Hodgkin’s lymphoma of bone in children. J Bone Joint Surg Am. 2006;88(3):583-594. doi:10.2106/JBJS.D.01967
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[44] O’Connor AR, Birchall JD, O’Connor SR, Bessell E. The value of 99mTc-MDP bone scintigraphy in staging primary lymphoma of bone. Nucl Med Commun. 2007;28(7):529-531. doi:10.1097/MNM.0b013e3281e2c861
[45] Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32(27):3059-3068. doi:10.1200/JCO.2013.54.8800
[46] Anderson JR, Armitage JO, Weisenburger DD. Epidemiology of the non-Hodgkin’s lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin’s Lymphoma Classification Project. Ann Oncol. 1998;9(7):717-720. doi:10.1023/a:1008265532487
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[48] Beal K, Allen L, Yahalom J. Primary bone lymphoma: treatment results and prognostic factors with long-term follow-up of 82 patients. Cancer. 2006;106(12):2652-2656. doi:10.1002/
[2] Bayrakci K, Yildiz Y, Saglik Y, et al. Primary lymphoma of bones. Int Orthop. 2001;25(2):123-126. doi:10.1007/s002640100224
[3] Baar J, Burkes RL, Gospodarowicz M. Primary non-Hodgkin’s lymphoma of bone. Semin Oncol. 1999;26(3):270-275.
[4] Heyning FH, Hogendoorn PC, Kramer MH, et al. Primary non-Hodgkin’s lymphoma of bone: a clinicopathological investigation of 60 cases. Leukemia. 1999;13(12):2094-2098. doi:10.1038/sj.leu.2401582
[5] Brousse C, Baumelou E, Morel P. Primary lymphoma of bone: a prospective study of 28 cases. Joint Bone Spine. 2000;67(5):446-451.
[6] Lucraft HH. Primary lymphoma of bone: a review of 13 cases emphasizing orthopaedic problems. Clin Oncol (R Coll Radiol). 1991;3(5):265-269. doi:10.1016/s0936-6555(05)80879-9
[7] Collins GS, Reitsma JB, Altman DG, Moons KGM. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD Statement. BMC Med. 2015;13:1. doi:10.1186/s12916-014-0241-z
[8] What is a Cancer Registry? SEER. https://seer.cancer.gov/registries/cancer_registry/index.html. Accessed July 3, 2024.
[9] Vijayvargiya A, Sinha A, Gehlot N, Jena A, Kumar R, Moran K. S-WD-EEMD: A hybrid framework for imbalanced sEMG signal analysis in diagnosis of human knee abnormality. PLoS One. 2024;19(5):e0301263. doi:10.1371/journal.pone.0301263
[10] Chen CC, Ting WC, Lee HC, Chang CC, Lin TC, Yang SF. A Cost-Effective Model for Predicting Recurrent Gastric Cancer Using Clinical Features. Diagnostics (Basel). 2024;14(8):842. doi:10.3390/diagnostics14080842
[11] Swain BK, Mohapatra S, Mishra M, Sharma R. A unified approach for Parkinson’s disease recognition: imbalance mitigation and grid search optimized boosting with LightGBM. Med Biol Eng Comput. June 2024. doi:10.1007/s11517-024-03139-3
[12] Kuang B, Zhang J, Zhang M, Xia H, Qiang G, Zhang J. Advancing NSCLC pathological subtype prediction with interpretable machine learning: a comprehensive radiomics-based approach. Front Med (Lausanne). 2024;11:1413990. doi:10.3389/fmed.2024.1413990
[13] Zhu M, Han F, Gao J, et al. Clinically Available and Reproducible Prediction Models for IDH and CDKN2A/B Gene Status in Adult-type Diffuse Gliomas. Acad Radiol. June 2024:S1076-6332(24)00379-9. doi:10.1016/j.acra.2024.06.020
[14] Lee TF, Liu YH, Chang CH, et al. Development of a risk prediction model for radiation dermatitis following proton radiotherapy in head and neck cancer using ensemble machine learning. Radiat Oncol. 2024;19(1):78. doi:10.1186/s13014-024-02470-1
[15] Harrell FE, Califf RM, Pryor DB, Lee KL, Rosati RA. Evaluating the yield of medical tests. JAMA. 1982;247(18):2543-2546.
[16] Kramer AA, Zimmerman JE. Assessing the calibration of mortality benchmarks in critical care: The Hosmer-Lemeshow test revisited. Crit Care Med. 2007;35(9):2052-2056. doi:10.1097/01.CCM.0000275267.64078.B0
[17] Roth AE. Lloyd Shapley (1923-2016). Nature. 2016;532(7598):178. doi:10.1038/532178a
[18] Ogami C, Tsuji Y, Seki H, et al. An artificial neural network-pharmacokinetic model and its interpretation using Shapley additive explanations. CPT Pharmacometrics Syst Pharmacol. 2021;10(7):760-768. doi:10.1002/psp4.12643
[19] Zheng P, Yu Z, Li L, et al. Predicting Blood Concentration of Tacrolimus in Patients With Autoimmune Diseases Using Machine Learning Techniques Based on Real-World Evidence. Front Pharmacol. 2021;12:727245. doi:10.3389/fphar.2021.727245
[20] Li W, Song Y, Chen K, et al. Predictive model and risk analysis for diabetic retinopathy using machine learning: a retrospective cohort study in China. BMJ Open. 2021;11(11):e050989. doi:10.1136/bmjopen-2021-050989
[21] Dürr HR, Müller PE, Hiller E, et al. Malignant lymphoma of bone. Arch Orthop Trauma Surg. 2002;122(1):10-16. doi:10.1007/s004020100316
[22] Zhang X, Zhu J, Song Y, Ping L, Zheng W. Clinical characterization and outcome of primary bone lymphoma: a retrospective study of 61 Chinese patients. Sci Rep. 2016;6:28834. doi:10.1038/srep28834
[23] Huang JJ, Xia Y, Zhu YJ, et al. Clinical characterization and prognostic factors of primary lymphoma of bone in case of Chinese patients. Med Oncol. 2011;28 Suppl 1:S476-482. doi:10.1007/s12032-010-9666-1
[24] Liu CX, Xu TQ, Xu L, et al. Primary lymphoma of bone: a population-based study of 2558 patients. Ther Adv Hematol. 2020;11:2040620720958538. doi:10.1177/2040620720958538
[25] Reimer RR, Chabner BA, Young RC, Reddick R, Johnson RE. Lymphoma presenting in bone: results of histopathology, staging, and therapy. Ann Intern Med. 1977;87(1):50-55. doi:10.7326/0003-4819-87-1-50
[26] Hernandez E, Rowan R, Randall M. A Case of Extranodal Metastasis of Primary Bone Lymphoma in the Lower Extremity. J Am Podiatr Med Assoc. 2018;108(1):52-57. doi:10.7547/15-115
[27] Mikhaeel NG. Primary bone lymphoma. Clin Oncol (R Coll Radiol). 2012;24(5):366-370. doi:10.1016/j.clon.2012.02.006
[28] Lugtenburg PJ, Lyon AR, Marks R, Luminari S. Treatment of aggressive non-Hodgkin’s lymphoma in frail patients: cardiac comorbidities and advanced age. Future Oncol. 2019;15(11):1197-1205. doi:10.2217/fon-2019-0019
[29] Wang HH, Dai KN, Li AB. A Nomogram Predicting Overall and Cancer-Specific Survival of Patients with Primary Bone Lymphoma: A Large Population-Based Study. Biomed Res Int. 2020;2020:4235939. doi:10.1155/2020/4235939
[30] Sun B, Xia Y, Guo Y, He C, Wang W. Development and Validation of Prognostic Nomograms for Patients with Primary Gastrointestinal Non-Hodgkin Lymphomas. Dig Dis Sci. 2020;65(12):3570-3582. doi:10.1007/s10620-020-06078-9
[31] Kühnl A, Cunningham D, Counsell N, et al. Outcome of elderly patients with diffuse large B-cell lymphoma treated with R-CHOP: results from the UK NCRI R-CHOP14v21 trial with combined analysis of molecular characteristics with the DSHNHL RICOVER-60 trial. Ann Oncol. 2017;28(7):1540-1546. doi:10.1093/annonc/mdx128
[32] Beal K, Allen L, Yahalom J. Primary bone lymphoma: treatment results and prognostic factors with long-term follow-up of 82 patients. Cancer. 2006;106(12):2652-2656. doi:10.1002/cncr.21930
[33] Alencar A, Pitcher D, Byrne G, Lossos IS. Primary bone lymphoma--the University of Miami experience. Leuk Lymphoma. 2010;51(1):39-49. doi:10.3109/10428190903308007
[34] Moulton VR. Sex Hormones in Acquired Immunity and Autoimmune Disease. Front Immunol. 2018;9:2279. doi:10.3389/fimmu.2018.02279
[35] Pfreundschuh M, Kuhnt E, Trümper L, et al. CHOP-like chemotherapy with or without rituximab in young patients with good-prognosis diffuse large-B-cell lymphoma: 6-year results of an open-label randomised study of the MabThera International Trial (MInT) Group. Lancet Oncol. 2011;12(11):1013-1022. doi:10.1016/S1470-2045(11)70235-2
[36] Aspelund A, Antila S, Proulx ST, et al. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. J Exp Med. 2015;212(7):991-999. doi:10.1084/jem.20142290
[37] Scott DW, Gascoyne RD. The tumour microenvironment in B cell lymphomas. Nat Rev Cancer. 2014;14(8):517-534. doi:10.1038/nrc3774
[38] Loghavi S, Alayed K, Aladily TN, et al. Stage, age, and EBV status impact outcomes of plasmablastic lymphoma patients: a clinicopathologic analysis of 61 patients. J Hematol Oncol. 2015;8:65. doi:10.1186/s13045-015-0163-z
[39] Tse E, Kwong YL. How I treat NK/T-cell lymphomas. Blood. 2013;121(25):4997-5005. doi:10.1182/blood-2013-01-453233
[40] Ramadan KM, Shenkier T, Sehn LH, Gascoyne RD, Connors JM. A clinicopathological retrospective study of 131 patients with primary bone lymphoma: a population-based study of successively treated cohorts from the British Columbia Cancer Agency. Ann Oncol. 2007;18(1):129-135. doi:10.1093/annonc/mdl329
[41] Shoji H, Miller TR. Primary reticulum cell sarcoma of bone. Significance of clinical features upon the prognosis. Cancer. 1971;28(5):1234-1244. doi:10.1002/1097-0142(1971)28:5<1234::aid-cncr2820280522>3.0.co;2-l
[42] Glotzbecker MP, Kersun LS, Choi JK, Wills BP, Schaffer AA, Dormans JP. Primary non-Hodgkin’s lymphoma of bone in children. J Bone Joint Surg Am. 2006;88(3):583-594. doi:10.2106/JBJS.D.01967
[43] Park YH, Kim S, Choi SJ, et al. Clinical impact of whole-body FDG-PET for evaluation of response and therapeutic decision-making of primary lymphoma of bone. Ann Oncol. 2005;16(8):1401-1402. doi:10.1093/annonc/mdi234
[44] O’Connor AR, Birchall JD, O’Connor SR, Bessell E. The value of 99mTc-MDP bone scintigraphy in staging primary lymphoma of bone. Nucl Med Commun. 2007;28(7):529-531. doi:10.1097/MNM.0b013e3281e2c861
[45] Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32(27):3059-3068. doi:10.1200/JCO.2013.54.8800
[46] Anderson JR, Armitage JO, Weisenburger DD. Epidemiology of the non-Hodgkin’s lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin’s Lymphoma Classification Project. Ann Oncol. 1998;9(7):717-720. doi:10.1023/a:1008265532487
[47] Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12(20 Pt 2):6243s-6249s. doi:10.1158/1078-0432.CCR-06-0931
[48] Beal K, Allen L, Yahalom J. Primary bone lymphoma: treatment results and prognostic factors with long-term follow-up of 82 patients. Cancer. 2006;106(12):2652-2656. doi:10.1002/
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