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

被引:1107
作者
Sehn, Laurie H.
Berry, Brian
Chhanabhai, Mukesh
Fitzgerald, Catherine
Gill, Karamjit
Hoskins, Paul
Klasa, Richard
Savage, Kerry J.
Shenkier, Tamara
Sutherland, Judy
Gascoyne, Randy D.
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
关键词
D O I
10.1182/blood-2006-08-038257
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
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页码:1857 / 1861
页数:5
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