Abstract:
:The International Prognostic Index (IPI) has been the basis for determining prognosis in patients with aggressive non-Hodgkin lymphoma (NHL) for the past 20 years. Using raw clinical data from the National Comprehensive Cancer Network (NCCN) database collected during the rituximab era, we built an enhanced IPI with the goal of improving risk stratification. Clinical features from 1650 adults with de novo diffuse large B-cell lymphoma (DLBCL) diagnosed from 2000-2010 at 7 NCCN cancer centers were assessed for their prognostic significance, with statistical efforts to further refine the categorization of age and normalized LDH. Five predictors (age, lactate dehydrogenase (LDH), sites of involvement, Ann Arbor stage, ECOG performance status) were identified and a maximum of 8 points assigned. Four risk groups were formed: low (0-1), low-intermediate (2-3), high-intermediate (4-5), and high (6-8). Compared with the IPI, the NCCN-IPI better discriminated low- and high-risk subgroups (5-year overall survival [OS]: 96% vs 33%) than the IPI (5 year OS: 90% vs 54%), respectively. When validated using an independent cohort from the British Columbia Cancer Agency (n = 1138), it also demonstrated enhanced discrimination for both low- and high-risk patients. The NCCN-IPI is easy to apply and more powerful than the IPI for predicting survival in the rituximab era.
journal_name
Bloodjournal_title
Bloodauthors
Zhou Z,Sehn LH,Rademaker AW,Gordon LI,Lacasce AS,Crosby-Thompson A,Vanderplas A,Zelenetz AD,Abel GA,Rodriguez MA,Nademanee A,Kaminski MS,Czuczman MS,Millenson M,Niland J,Gascoyne RD,Connors JM,Friedberg JW,Winter JNdoi
10.1182/blood-2013-09-524108subject
Has Abstractpub_date
2014-02-06 00:00:00pages
837-42issue
6eissn
0006-4971issn
1528-0020pii
blood-2013-09-524108journal_volume
123pub_type
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