Clinical Prognostic Models in Diffuse Large B Cell Lymphoma Patients are Still Essential in the Rituximab EraRenata de Oliveira Costa1,2*, Abrahão Hallack Neto3, Sheila Siqueira1, Luis Alberto de Padua Covas Lage1, Henrique Moura de Paula4 and Juliana Pereira1
- *Corresponding Author:
- Renata de Oliveira Costa
Avenida Doutor Bernardino de Campos 632 Apartamento 81
CEP, Santos-SP, 11065-002, Brazil
E-mail: [email protected]
Received date: May 16, 2016; Accepted date: July 11, 2016; Published date: July 18, 2016
Citation: Costa RO, Neto AH, Siqueira S, Lage LAPC, Paula HM, et al. (2016) Clinical Prognostic Models in Diffuse Large B Cell Lymphoma Patients are Still Essential in the Rituximab Era. J Hematol Thrombo Dis 4:248. doi:10.4172/2329-8790.1000248
Copyright: © 2016, Costa RO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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.