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Blood Res 2015; 50(3):
Published online September 22, 2015
https://doi.org/10.5045/br.2015.50.3.160
© The Korean Society of Hematology
Prediction of survival by applying current prognostic models in diffuse large B-cell lymphoma treated with R-CHOP followed by autologous transplantation
1Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
3Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
4Department of Internal Medicine, The Catholic University of Korea College of Medicine, Suwon, Korea.
5Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
6Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea.
7Department of Internal Medicine, Samsung Medical Center, Seoul, Korea.
8Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
9Department of Internal Medicine, National Cancer Center, Goyang, Korea.
10Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
11Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
12Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea.
13Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
14Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea.
Correspondence to : Correspondence to Hong Ghi Lee, M.D., Ph.D. Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea. Tel: +82-2-2030-7538, Fax: +82-2-2030-7695, mlee@kuh.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background
Among the currently available prognostic models for diffuse large B-cell lymphoma (DLBCL), we investigated to determine which is most adoptable for DLBCL patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) followed by upfront autologous stem cell transplantation (auto-SCT).
Methods
We retrospectively evaluated survival differences among risk groups based on the International Prognostic Index (IPI), the age-adjusted IPI (aaIPI), the revised IPI (R-IPI), and the National Comprehensive Cancer Network IPI (NCCN-IPI) at diagnosis in 63 CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT.
Results
At the time of auto-SCT, 74.6% and 25.4% of patients had achieved complete remission and partial remission after R-CHOP, respectively. As a whole, the 5-year overall (OS) and progression-free survival (PFS) rates were 78.8% and 74.2%, respectively. The 5-year OS and PFS rates according to the IPI, aaIPI, R-IPI, and NCCN-IPI did not significantly differ among the risk groups for each prognostic model (
Conclusion
There was no ideal prognostic model among those currently available for CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT.
Keywords Diffuse large B-cell lymphoma, Hematopoietic stem cell transplantation, Autologous transplantation, Rituximab, Prognostic groups
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Original Article
Blood Res 2015; 50(3): 160-166
Published online September 22, 2015 https://doi.org/10.5045/br.2015.50.3.160
Copyright © The Korean Society of Hematology.
Prediction of survival by applying current prognostic models in diffuse large B-cell lymphoma treated with R-CHOP followed by autologous transplantation
Hong Ghi Lee1*, Sung-Yong Kim1, Inho Kim2, Yeo-Kyeoung Kim3, Jeong-A Kim4, Yang Soo Kim5, Ho Sup Lee5, Jinny Park6, Seok Jin Kim7, Hyeok Shim8, Hyeon Seok Eom9, Byeong-Bae Park10, Junglim Lee11, Sung Kyu Park12, June-Won Cheong13, and Keon Woo Park14
1Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
3Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
4Department of Internal Medicine, The Catholic University of Korea College of Medicine, Suwon, Korea.
5Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
6Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea.
7Department of Internal Medicine, Samsung Medical Center, Seoul, Korea.
8Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
9Department of Internal Medicine, National Cancer Center, Goyang, Korea.
10Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
11Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
12Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea.
13Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
14Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea.
Correspondence to:Correspondence to Hong Ghi Lee, M.D., Ph.D. Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea. Tel: +82-2-2030-7538, Fax: +82-2-2030-7695, mlee@kuh.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Among the currently available prognostic models for diffuse large B-cell lymphoma (DLBCL), we investigated to determine which is most adoptable for DLBCL patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) followed by upfront autologous stem cell transplantation (auto-SCT).
Methods
We retrospectively evaluated survival differences among risk groups based on the International Prognostic Index (IPI), the age-adjusted IPI (aaIPI), the revised IPI (R-IPI), and the National Comprehensive Cancer Network IPI (NCCN-IPI) at diagnosis in 63 CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT.
Results
At the time of auto-SCT, 74.6% and 25.4% of patients had achieved complete remission and partial remission after R-CHOP, respectively. As a whole, the 5-year overall (OS) and progression-free survival (PFS) rates were 78.8% and 74.2%, respectively. The 5-year OS and PFS rates according to the IPI, aaIPI, R-IPI, and NCCN-IPI did not significantly differ among the risk groups for each prognostic model (
Conclusion
There was no ideal prognostic model among those currently available for CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT.
Keywords: Diffuse large B-cell lymphoma, Hematopoietic stem cell transplantation, Autologous transplantation, Rituximab, Prognostic groups
Fig 1.
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Probability of overall survival (OS)
Fig 2.
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Probability of overall survival (OS)
Fig 3.
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Probability of overall survival (OS)
Fig 4.
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Probability of overall survival (OS)
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Patient and disease characteristics at diagnosis. a)B symptoms indicate systemic symptoms such as fever, night sweats, and weight loss, which are associated with non-Hodgkin's lymphoma..
Abbreviations: LDH, lactate dehydrogenase; ECOG, Eastern Cooperative Oncology Group; PS, performance status..
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The numbers and percentages of patients classified into the risk groups of each prognostic model. Abbreviations: IPI, International Prognostic Index; NCCN, National Comprehensive Cancer Network..
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Treatments and responses before auto-SCT. Abbreviations: auto-SCT, autologous stem cell transplantation; R-CHOP, rituximab+cyclophosphamide+adriamycin+vincristine+ prednisolone; CR, complete remission; PR, partial remission; RT, radiation therapy; SCT, stem cell transplantation..
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Transplantation characteristics. Abbreviations: SCT, stem cell transplantation; G-CSF, granulocytecolony stimulating factor; BU, busulfan; CY, cyclophosphamide; VP-16, etoposide; MEL, melphalan; MITO, mitoxantrone; ARA-C, cytosine arabinoside; BCNU, carmustine; IFOS, ifosfamide; CARB, carboplatin; CD, cluster of differentiation; ANC, absolute neutrophil count; PLT, platelet..
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Outcomes of high risk diffuse large B-cell lymphoma patients treated with upfront autologous stem cell transplantation. Abbreviations: aaIPI, age-adjusted International Prognostic Index; high-int, high intermediate; NHL, non-Hodgkin's lymphoma; OS, overall survival; DFS, disease-free survival; DLBCL, diffuse large B-cell lymphoma; PFS, progression-free survival; EFS, event-free survival..
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