Splenic Marginal Zone Lymphoma Clinical Trial
Official title:
Integrated Molecular and Clinical Profiling to Optimize Outcome Prediction in Splenic Marginal Zone Lymphoma
The study aims at developing and validating an integrated clinico-molecular model for an accurate survival prognostication in newly diagnosed SMZL.
Mutation analysis will be performed by targeted deep next generation sequencing of tumor
genomic DNA. Deletion of 7q will be assessed by FISH on nuclei isolated from tumor tissues.
Immunoglobulin gene rearrangement and mutation status will be analyzed on tumor genomic DNA
by PCR and Sanger sequencing. The methylation status of target genes will be assessed by
methylation specific PCR on tumor genomic DNA.
The adjusted association between exposure variables and OS will be estimated by Cox
regression. This approach will provide the covariates independently associated with OS that
will be utilized in the development of a hierarchical molecular model to predict OS. The
hierarchical order of relevance in predicting OS among covariates will be established by
recursive partitioning analysis. An amalgamation algorithm will be used to merge terminal
nodes showing homogenous OS. The discrimination capacity of the model will be assessed by
calculating the c-index. Relative survival analysis will be used to provide a measure of the
excess mortality experienced by patient's subgroups stratified according to the developed
hierarchical molecular models, irrespective of whether the excess mortality is directly or
indirectly attributable to the disease. The model developed in the training set will be
tested in the validation sets and the model performance (c-index) in the validation set will
be compared with that in the training set.
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