The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP
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Sehn, Laurie H.
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Sehn, Laurie H.
Berry, Brian
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Berry, Brian
Chhanabhai, Mukesh
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Chhanabhai, Mukesh
Fitzgerald, Catherine
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Fitzgerald, Catherine
Gill, Karamjit
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Gill, Karamjit
Hoskins, Paul
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Hoskins, Paul
Klasa, Richard
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Klasa, Richard
Savage, Kerry J.
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Savage, Kerry J.
Shenkier, Tamara
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Shenkier, Tamara
Sutherland, Judy
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Sutherland, Judy
Gascoyne, Randy D.
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Gascoyne, Randy D.
Connors, Joseph M.
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机构:British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
Connors, Joseph M.
机构:
[1] British Columbia Canc Agcy, Vancouver Clin, Div Med Oncol, Vancouver, BC V5Z 4E6, Canada
[2] British Columbia Canc Agcy, Dept Pathol, Vancouver, BC V5Z 4E6, Canada
[3] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity, with patients exhibiting a wide range of outcomes. The addition of rituximab to CHOP chemotherapy (R-CHOP)has led to a marked improvement in survival and has called into question the significance of previously recognized prognostic markers. Since randomized controlled trials of R-CHOP in DLBCL have included select subgroups of patients, the utility of the International Prognostic Index (IPI) has not been reassessed. We performed a retrospective analysis of patients with DLBCL treated with R-CHOP in the province of British Columbia to assess the value of the IN in the era of immunochemotherapy. The IPI remains predictive, but it identifies only 2 risk groups. Redistribution of the IPI factors into a revised IPI (R-IPI) provides a more clinically useful prediction of outcome. The R-IPI identifies 3 distinct prognostic groups with a very good (4-year progression-free survival [PFS] 94%, overall survival [OS] 94%), good (4-year PFS 80%, OS 79%), and poor (4-year PFS 53%, OS 55%) outcome, respectively (P <.001). The IN (or R-IPI) no longer identifies a risk group with less than a 50% chance of survival. In the era of R-CHOP treatment, the R-IPI is a clinically useful prognostic index that may help guide treatment planning and interpretation of clinical trials.