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Journal of Hematology & Thromboembolic Diseases

Journal of Hematology & Thromboembolic Diseases
Open Access

ISSN: 2329-8790

+44 1478 350008

Abstract

Clinical Prognostic Models in Diffuse Large B Cell Lymphoma Patients are Still Essential in the Rituximab Era

Renata de Oliveira Costa, Abrahão Hallack Neto, Sheila Siqueira, Luis Alberto de Padua Covas Lage, Henrique Moura de Paula and Juliana Pereira

Introduction: To evaluate a new enhanced IPI proposal by the National Comprehensive Cancer Network (NCCNIPI) in DLBCL patients, we compared the IPI, R-IPI, and NCCN-IPI in DLBCL patients treated with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone (R-CHOP).

Methods: From June 2008 to January 2012, we retrospectively evaluated 146 DLBCL patients treated with RCHOP- 21 referred for cancer treatment in a single institution in Brazil. Patients' clinical data were assessed to calculate the IPI, R-IPI, and NCCN-IPI.

Results: Patients' median age was 58.9 years (range 16-86); 85 (57.8%) were female. According to IPI, risk categories were low (n=41, 28.1%), low-intermediate (n=43, 29.5%), high-intermediate (n=37, 25.3%), and high (n=25, 17.1%). Using R-IPI, risk categories were very good (n=19, 13%), good (n=65, 44.5%), and poor (n=62, 42.5%). According to NCCN-IPI, risk categories were low (n=12/147, 8.2%), low-intermediate (n=52/147, 35.6%), high-intermediate (n=62/147, 42.5%), and high (n=20/147, 13.7%). The median follow up was 42.8 months (0.6-71.2) with an overall survival (OS) at 48 months of 73.8% and 84.3% of PFS. Using IPI, the OS at was higher for low and low- intermediate risk than high and high-intermediate risk patients (85.9% vs. 59.2% p<0.001). The RIPI showed significant differences in OS (100% vs. 83.2% vs. 57.5% p<0.001) but not for PFS (p=0.67) among very good, good and poor risk groups. The NCCN-IPI demonstrated significant differences in OS (p<0.001) among lowintermediate, high-intermediate, and high-risk groups, with the high-risk group exhibiting worse OS (35% at 48 months) but not for PFS (0.166). According to IPI, the OS in high-intermediate and high-risk patients was 59.2%. Conclusion: In our study, the NCCN-IPI (but not the IPI or R-IPI) was able to discriminate a group of patients of higher risk of DLBCL treated with R-CHOP with worse median OS.

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