TY - JOUR
T1 - Prognostic factors in patients with diffuse large B cell lymphoma
T2 - Before and after the introduction of rituximab
AU - Ngo, Lynette
AU - Hee, Siew Wan
AU - Lim, Lay Cheng
AU - Tao, Miriam
AU - Quek, Richard
AU - Yap, Swee Peng
AU - Loong, Er Li
AU - Sng, Ivy
AU - Hwan-Cheong, Tan Leonard
AU - Ang, Mei Kim
AU - Ngeow, Joanne
AU - Tham, Chee Kian
AU - Tan, Min Han
AU - Lim, Soon Thye
PY - 2008/3
Y1 - 2008/3
N2 - This study attempted to evaluate the usefulness of the International Prognostic Index (IPI) as a prognostic model in patients treated with R-CHOP (rituximab, cyclophosphamide, vincristine, adriamycin and prednisolone) chemotherapy. We compared 279 patients with DLBCL. Among them, 183 received CHOP while 96 received R-CHOP. Results showed that there were no statistically significant differences between the two groups of patients in terms of both the patient and the lymphoma characteristics. The estimated 2-year survival was significantly higher among patients treated with R-CHOP compared to CHOP alone (85.6% vs. 64.7%, P = 0.004). Both the IPI and age-adjusted IPI were less useful as prognostic models in patients receiving R-CHOP compared to CHOP. In the multivariate analysis, age ≥ 60, elevated serum LDH, low serum albumin and advanced stages of disease were each independently associated with decreased survival in patients treated with CHOP. In contrast, among those treated with R-CHOP, only male sex and advanced stage of disease were each independently associated with decreased survival. Using these two factors, patients treated with R-CHOP could be separated into three prognostic groups with 5-year estimated survival ranging from 47% to 100% (P < 0.0001). In summary, we can conclude that with the significant improvement in survival following the use of rituximab, the relevance of previously recognized prognostic factors has to be reassessed and re-evaluated.
AB - This study attempted to evaluate the usefulness of the International Prognostic Index (IPI) as a prognostic model in patients treated with R-CHOP (rituximab, cyclophosphamide, vincristine, adriamycin and prednisolone) chemotherapy. We compared 279 patients with DLBCL. Among them, 183 received CHOP while 96 received R-CHOP. Results showed that there were no statistically significant differences between the two groups of patients in terms of both the patient and the lymphoma characteristics. The estimated 2-year survival was significantly higher among patients treated with R-CHOP compared to CHOP alone (85.6% vs. 64.7%, P = 0.004). Both the IPI and age-adjusted IPI were less useful as prognostic models in patients receiving R-CHOP compared to CHOP. In the multivariate analysis, age ≥ 60, elevated serum LDH, low serum albumin and advanced stages of disease were each independently associated with decreased survival in patients treated with CHOP. In contrast, among those treated with R-CHOP, only male sex and advanced stage of disease were each independently associated with decreased survival. Using these two factors, patients treated with R-CHOP could be separated into three prognostic groups with 5-year estimated survival ranging from 47% to 100% (P < 0.0001). In summary, we can conclude that with the significant improvement in survival following the use of rituximab, the relevance of previously recognized prognostic factors has to be reassessed and re-evaluated.
KW - Diffuse large B cell lymphoma
KW - Prognostic factors
KW - Rituximab
UR - http://www.scopus.com/inward/record.url?scp=39749180292&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=39749180292&partnerID=8YFLogxK
U2 - 10.1080/10428190701809156
DO - 10.1080/10428190701809156
M3 - Article
C2 - 18297522
AN - SCOPUS:39749180292
SN - 1042-8194
VL - 49
SP - 462
EP - 469
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 3
ER -
