| Autor: |
Carlos, Montalbán, Antonio, Díaz-López, Ivan, Dlouhy, Jordina, Rovira, Armando, Lopez-Guillermo, Sara, Alonso, Alejandro, Martín, Juan M, Sancho, Olga, García, Jose M, Sánchez, Mario, Rodríguez, Silvana, Novelli, Antonio, Salar, Antonio, Gutiérrez, Maria J, Rodríguez-Salazar, Mariana, Bastos, Juan F, Domínguez, Rubén, Fernández, Sonia, Gonzalez de Villambrosia, José A, Queizan, Raul, Córdoba, Raquel, de Oña, Andrés, López-Hernandez, Julian M, Freue, Heidys, Garrote, Lourdes, López, Ana M, Martin-Moreno, Jose, Rodriguez, Víctor, Abraira, Juan F, García, María, Casanova |
| Rok vydání: |
2016 |
| Předmět: |
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| Zdroj: |
British journal of haematology. 176(6) |
| ISSN: |
1365-2141 |
| Popis: |
The study included 1848 diffuse large B-cell lymphoma (DLBCL)patients treated with chemotherapy/rituximab. The aims were to validate the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) and explore the effect of adding high Beta-2 microglobulin (β2M), primary extranodal presentation and intense treatment to the NCCN-IPI variables in order to develop an improved index. Comparing survival curves, NCCN-IPI discriminated better than IPI, separating four risk groups with 5-year overall survival rates of 93%, 83%, 67% and 49%, but failing to identify a true high-risk population. For the second aim the series was split into training and validation cohorts: in the former the multivariate model identified age, lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, Stage III-IV, and β2M as independently significant, whereas the NCCN-IPI-selected extranodal sites, primary extranodal presentation and intense treatments were not. These results were confirmed in the validation cohort. The Grupo Español de Linfomas/Trasplante de Médula ósea (GELTAMO)-IPI developed here, with 7 points, significantly separated four risk groups (0, 1-3, 4 or ≥5 points) with 11%, 58%, 17% and 14% of patients, and 5-year overall survival rates of 93%, 79%, 66% and 39%, respectively. In the comparison GELTAMO IPI discriminated better than the NCCN-IPI. In conclusion, GELTAMO-IPI is more accurate than the NCCN-IPI and has statistical and practical advantages in that the better discrimination identifies an authentic high-risk group and is not influenced by primary extranodal presentation or treatments of different intensity. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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