Baimpa et al identified risk factors associated with malignant lymphoma in a patient with primary Sjogren syndrome. These can help to identify a patient who may benefit from closer monitoring. The authors are from the National University of Athens.
Patient selection: primary Sjogren syndrome
Outcome: malignant lymphoma (most often MALT or diffuse large B-cell lymphoma)
Parameters:
(1) absolute neutrophil count per µL
(2) cryoglobulinemia
(3) splenomegaly
(4) lymphadenopathy
(5) serum C4 concentration
|
Parameter
|
Finding
|
Points
|
Odds Ratio
|
|
absolute neutrophil
|
>= 1,500 per µL
|
0
|
1
|
|
|
< 1,500 per µL (neutropenia)
|
1
|
9.0
|
|
cryoglobulinemia
|
absent
|
0
|
1
|
|
|
present
|
1
|
2.9
|
|
splenomegaly
|
absent
|
0
|
1
|
|
|
present
|
1
|
4.0
|
|
lymphadenopathy
|
absent
|
0
|
1
|
|
|
present
|
1
|
2.6
|
|
serum C4
|
normal or high
|
0
|
1
|
|
|
low (< 10 mg/dL)
|
1
|
3.3
|
total number of risk factors =
= SUM(points for all 5 parameters)
cumulative product of odds ratios =
= PRODUCT(odds ratios for the 5 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 5
• The presence of no risk factors was associated with a 4% risk of lymphoma.
• The presence of one or more risk factors was associated with 21% risk of lymphoma.
• minimum product of odds ratios: 1
• maximum product of odds ratios: 896
• The prevalence of lymphoma increases over time.
