Blood Res 2017; 52(4):
Published online December 31, 2017
https://doi.org/10.5045/br.2017.52.4.276
© The Korean Society of Hematology
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Correspondence to : Cheolwon Suh, M.D., Ph.D. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. csuh@amc.seoul.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.
The International Prognostic Index (IPI) has been a useful tool for predicting the prognosis of aggressive non-Hodgkin lymphoma in the last 20 years. Herein, we aimed to develop a new prognostic model for diffuse large B-cell lymphoma (DLBCL) in the rituximab era.
Between March 2004 and June 2012, patients with DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy regimen were identified in the database of the Asan Medical Center (AMC) Lymphoma Registry. The primary and secondary endpoints were a new prognostic index for DLBCL and validation of the National Comprehensive Cancer Network-International Prognostic Index in our cohort, respectively.
The AMC cohort comprised 621 patients. The median follow-up duration was 43.3 months (range, 6.2?122.5 mo). Univariate analysis revealed that age (≤60 vs. >60 yr), lactate dehydrogenase (LDH; within normal vs. increased), Eastern Cooperative Oncology Group performance status (ECOG PS; 0 or 1 vs. ≥2), advanced stage (Ann Arbor stage I/II vs. III/IV), extra-nodal involvement (≤1 vs. >1), B symptoms (no vs. yes), and beta-2 microglobulin (β2MG, ≤2.5 vs. >2.5) can be used to predict overall survival (OS). In multivariate analysis, only age, LDH, ECOG performance status, and β2MG were significantly associated with OS, and we developed a new prognostic model with these 4 factors. The new prognostic model showed better discriminative power compared with the classic IPI.
Our new prognostic index model for DLBCL in the rituximab era has good discriminative power and is convenient to use.
Keywords Diffuse large B-cell lymphoma, Prognostic index, NCCN-IPI, β2-microglobulin
Blood Res 2017; 52(4): 276-284
Published online December 31, 2017 https://doi.org/10.5045/br.2017.52.4.276
Copyright © The Korean Society of Hematology.
Jihoon Kang, Shinkyo Yoon, and Cheolwon Suh*
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Correspondence to:Cheolwon Suh, M.D., Ph.D. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. csuh@amc.seoul.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.
The International Prognostic Index (IPI) has been a useful tool for predicting the prognosis of aggressive non-Hodgkin lymphoma in the last 20 years. Herein, we aimed to develop a new prognostic model for diffuse large B-cell lymphoma (DLBCL) in the rituximab era.
Between March 2004 and June 2012, patients with DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy regimen were identified in the database of the Asan Medical Center (AMC) Lymphoma Registry. The primary and secondary endpoints were a new prognostic index for DLBCL and validation of the National Comprehensive Cancer Network-International Prognostic Index in our cohort, respectively.
The AMC cohort comprised 621 patients. The median follow-up duration was 43.3 months (range, 6.2?122.5 mo). Univariate analysis revealed that age (≤60 vs. >60 yr), lactate dehydrogenase (LDH; within normal vs. increased), Eastern Cooperative Oncology Group performance status (ECOG PS; 0 or 1 vs. ≥2), advanced stage (Ann Arbor stage I/II vs. III/IV), extra-nodal involvement (≤1 vs. >1), B symptoms (no vs. yes), and beta-2 microglobulin (β2MG, ≤2.5 vs. >2.5) can be used to predict overall survival (OS). In multivariate analysis, only age, LDH, ECOG performance status, and β2MG were significantly associated with OS, and we developed a new prognostic model with these 4 factors. The new prognostic model showed better discriminative power compared with the classic IPI.
Our new prognostic index model for DLBCL in the rituximab era has good discriminative power and is convenient to use.
Keywords: Diffuse large B-cell lymphoma, Prognostic index, NCCN-IPI, β2-microglobulin
Overall survival and relapse-free survival of
Abbreviations: H, high-risk group; H-I, high-intermediate; L, low; L-I, low-intermediate.
Overall survival and relapse-free survival according to
Abbreviations: H, high-risk group; H-I, high-intermediate; IPI, International Prognostic Index; L, low; L-I, low-intermediate; NCCN-IPI, National Comprehensive Cancer Network-International Prognostic Index; RFS, relapse-free survival.
Abbreviation: ECOG PS, Eastern Cooperative Oncology Group performance status..
a)Lymphomatous involvement in bone marrow, CNS, liver/GI tract, or lung..
Abbreviation: ECOG PS, Eastern Cooperative Oncology Group performance status..
Abbreviation: ECOG PS, Eastern Cooperative Oncology Group performance status..
Abbreviations: H, high-risk group; H-I, high-intermediate; IPI, International Prognostic Index; L, low; L-I, low-intermediate; NCCN-IPI, National Comprehensive Cancer Network-International Prognostic Index; OS, overall survival; RFS, relapse-free survival..
Abbreviations: AUC, area under the curve; CI, confidence interval; IPI, International Prognostic Index; NCCN-IPI, National Comprehensive Cancer Network-International Prognostic Index..
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Overall survival and relapse-free survival of
Abbreviations: H, high-risk group; H-I, high-intermediate; L, low; L-I, low-intermediate.
|@|~(^,^)~|@|Overall survival and relapse-free survival according to
Abbreviations: H, high-risk group; H-I, high-intermediate; IPI, International Prognostic Index; L, low; L-I, low-intermediate; NCCN-IPI, National Comprehensive Cancer Network-International Prognostic Index; RFS, relapse-free survival.