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Titel: International prognostic indices in diffuse large B-cell lymphoma : a comparison of IPI, R-IPI, and NCCN-IPI
VerfasserIn: Ruppert, Amy S.
Dixon, Jesse G.
Salles, Gilles
Wall, Anna
Cunningham, David
Poeschel, Viola
Haioun, Corinne
Tilly, Herve
Ghesquieres, Herve
Ziepert, Marita
Flament, Jocelyne
Flowers, Christopher
Shi, Qian
Schmitz, Norbert
Sprache: Englisch
Titel: Blood
Bandnummer: 135
Heft: 23
Seiten: 2041-2048
Verlag/Plattform: ASH Publications
Erscheinungsjahr: 2020
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Great heterogeneity in survival exists for patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL). Three scoring systems incorporating simple clinical parameters (age, lactate dehydrogenase, number/sites of involvement, stage, performance status) are widely used: the International Prognostic Index (IPI), revised IPI (R-IPI), and National Comprehensive Cancer Network IPI (NCCN-IPI). We evaluated 2124 DLBCL patients treated from 1998 to 2009 with frontline rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP; or variant) across 7 multicenter randomized clinical trials to determine which scoring system best discriminates overall survival (OS). Median age was 63 years, and 56% of patients were male. Five-year OS estimates ranged from 54% to 88%, from 61% to 93%, and from 49% to 92% using the IPI, R-IPI, and NCCN-IPI, respectively. The NCCN-IPI had the greatest absolute difference in OS estimates between the highest- and lowest-risk groups and best discriminated OS (concordance index 5 0.632 vs 0.626 [IPI] vs 0.590 [R-IPI]). For each given IPI risk category, NCCN-IPI risk categories were significantly associated with OS (P £ .01); the reverse was not true, and the IPI did not provide additional significant prognostic information within all NCCN-IPI risk categories. Collectively, the NCCN-IPI outperformed the IPI and R-IPI. Patients with low-risk NCCN-IPI had favorable survival outcomes with little room for further improvement. In the rituximab era, none of the clinical risk scores identified a patient subgroup with long-term survival clearly <50%. Integrating molecular features of the tumor and microenvironment into the NCCN-IPI or IPI might better characterize a high-risk group for which novel treatment approaches are most needed. (Blood. 2020;135(23):2041-2048)
DOI der Erstveröffentlichung: 10.1182/blood.2019002729
URL der Erstveröffentlichung: http://dx.doi.org/10.1182/blood.2019002729
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-385953
hdl:20.500.11880/34777
http://dx.doi.org/10.22028/D291-38595
ISSN: 1528-0020
0006-4971
Datum des Eintrags: 16-Dez-2022
Bezeichnung des in Beziehung stehenden Objekts: Supplemental data
In Beziehung stehendes Objekt: https://ash.silverchair-cdn.com/ash/content_public/journal/blood/135/23/10.1182_blood.2019002729/2/bloodbld2019002729-suppl1.pdf?Expires=1672933276&Signature=CTPyUcr1oeyA5he~q6gl8Wqyki1bl3EfO~BoSG81DNdN8dFmWy5mc161Soj~ILMHnFF9JWbaaV5-NYEEY-WBx1niKnJYqcj6my~Epi2nMnI2RLeGH42WCZvC~ciw1JXbGwPU81lxxkiZFnZAyxb9qt9AGk6RT8MbPZkLaoc8OBt4fiOOJoKl~sYh3fBgP-ZKE47H9e6Ix0GLsMZfcxzjIFpzPkULlmjgkPCRwsAcWQbXcLKvyGBaJO9woAQRIDjZg6-GT1wYaje6dunjjt1omGPeWOoJrbLH83YRTyaAyqy9wv2zdhmCLlIwm~tpY5tjNcx0PdiSTkpOzAzHEDRGAA__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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