Publication: MYC and BCL-2 adjusted-International Prognostic Index (A-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP
Authors
Wang, Jing ; Zhou, Min ; Xu, Jing-Yan ; Yang, Yong-Gong ; Zhang, Qi-Guo ; Zhou, Rong-Fu ; Chen, Bing ; Ouyang, Jian ; Li, Cuiping
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Publisher
Universidad de Murcia. Departamento de BiologĂa Celular e HistologĂa
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DOI
10.14670/HH-11-673
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info:eu-repo/semantics/article
Description
Abstract
The International Prognostic Index (IPI) has
been the basis for determining prognosis in patients with
diffuse large B-cell lymphoma (DLBCL) for the past 20
years. The utility of the IPI must be reassessed in the era
of immunochemotherapy. Seven risk factors at diagnosis
were identified, and a maximum of 7 points were
assigned to each patient. Four risk groups were created:
low (0-1), low-intermediate (2-3), high-intermediate (4),
and high (5-7). Using MYC and BCL-2 clinical data
from the Drum Tower Hospital collected during the
rituximab era, we performed a retrospective analysis of
patients with DLBCL treated with R-CHOP and built an
biological markers adjusted IPI with the goal of
improving risk stratification.Clinical features from 60
adults with de novo DLBCL diagnosed from 2008-2013
were assessed for their prognostic significance. The IPI
remains predictive, but it cannot identify the high-risk
subgroup. Compared with the IPI, the MYC and BCL-2
adjusted-IPI (A-IPI) better discriminated patients in the
high-risk subgroup (4-year overall survival [OS]: 33.3%)
than did the IPI (4 year OS: 48.0%). In the era of RCHOP treatment, MYC and BCL-2 adjusted-IPI is more
powerful than the IPI for helping guide treatment
planning and interpretation of clinical trials.
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Citation
Histology and Histopathology, vol.31, nÂş3, (2016)
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