The Prognostic Value of Common Cardiovascular Biomarkers in the Survival of Patients with DLBCL
Yi XuYuanfei ShiJianai SunXiaolong ZhengXueying LiJinghan WangWenjuan YuHongyan TongJie JinWanzhuo Xie
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International Prognostic Index
The International Prognostic Index (IPI) is a clinical prognostic tool used for more than 20 years in the risk stratification of patients with de novo diffuse large B cell lymphoma (DLBCL) who rece...
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Cutaneous diffuse large B-cell lymphoma, leg type, is a malignant lymphoma of intermediate behavior, occurring mostly on leg(s) of elderly patients. This chapter describes the clinical features, histopathology, immunophenotype, molecular genetics, treatment and prognosis of diffuse large B-cell lymphoma, leg type. It is a matter of discussion whether diffuse large B-cell lymphoma, leg type, is a specific entity per se, or does simply represent a primary cutaneous variant of diffuse large B-cell lymphoma, unspecified. In fact, there are more similarities than differences between these groups, and it has been suggested that diffuse large B-cell lymphoma, leg type, should not be considered as a separate entity, but rather classified within the group of diffuse large B-cell lymphoma, unspecified. It must be remembered that diagnosis of cutaneous diffuse large B-cell lymphoma, leg type, is made only upon negative staging investigations, as any extracutaneous diffuse large B-cell lymphoma may involve the skin secondarily.
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The International Prognostic Index (IPI) has been a powerful tool for predicting post-treatment outcomes and comparing results across clinical trials in diffuse large B-cell lymphoma (DLBCL) for more than 20 years. Given that rituximab has improved survival across all risk groups since the late 1990s, investigators have created a new prognostic model based on a retrospective analysis of 1650 newly diagnosed DLBCL patients who received induction rituximab-based chemotherapy from 2000 to 2010 at seven centers in the National …
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Diffuse large B-cell lymphoma (DLBCL) is the most common subgroup of non-Hodgkin lymphoma.[1] The International Prognostic Index (IPI) was developed more than 20 years ago based on the clinical dat...
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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 R-CHOP 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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Despite advances in therapy, still up to one third of patients with diffuse large B-cell lymphoma (DLBCL) will ultimately die of their disease. The revised international prognostic index (R-IPI) is...
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Background: Elderly patients with diffuse large B-cell lymphoma (DLBCL) need thorough evaluation at diagnosis to select the most suitable approach. Different scores are used to stratify DLBCL cases according to their prognosis, but data are scarce in old patients. The Laboratory Prognostic Index (LAB-PI) [Martin-Moro. ASH 2022; abstract 320] has emerged as an interesting tool for this group of patients, due to its simplicity and accessibility, as it only includes three variables routinely tested in peripheral blood at DLBCL diagnosis: lactate dehydrogenase, hemoglobin, and beta-2 microglobulin. The aim was to compare the prognostic usefulness of validated prognostic indexes in old DLBCL patients, with a special focus on the LAB-PI score. Methods: Retrospective multicenter study (on behalf of the Spanish Lymphoma Group GELTAMO) including de novo DLBCL patients with ≥70 years old at diagnosis who received first-line therapy (N = 386). Four prognostic scores were calculated prior to treatment initiation: aaIPI, LAB-PI, NCCN-IPI, and GELTAMO-IPI. Descriptive statistics were applied to compare the different prognostic scores, which were analyzed for both event-free survival (EFS) and overall survival (OS) by Kaplan Meier curves and by the concordance C-index. In each score, risk clusters which showed no EFS difference, calculated by univariate hazard ratio (UV HR) Cox regression analysis, were grouped. Results: The series was composed of 386 DLBCL patients with a median age at diagnosis of 76 years (IQR 73–80) and a male:female ratio of 0.8:1. Patients presented with advanced stage were 254/386 (66%). The distribution of the prognostic groups (low, low-intermediate, high-intermediate, and high) among the four indexes was heterogeneous, as shown in Figure 1A when comparing LAB-PI with aaIPI and NCCN-IPI. No statistical EFS difference was seen between low and low-intermediate risk groups for aaIPI (UV HR 1.4, 95% CI: 0.8–2.6) and LAB-PI (UV HR 1.2, 95% CI: 0.8–1.9), so these clusters were grouped in each index. Three hundred and seventy-four patients (97%) were treated with anthracycline-based regimens (R-CHOP or R-miniCHOP). The median follow-up of the cohort was 34.2 months (IQR 15–61). EFS and OS curves according to each prognostic score are presented in Figure 1B. According to C-index, the most useful score to predict EFS was the LAB-PI (0.66). Keywords: Aggressive B-cell non-Hodgkin lymphoma, Diagnostic and Prognostic Biomarkers, Risk Models No conflicts of interests pertinent to the abstract.
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