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KMID : 0366220170520040276
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Korean Journal of Hematology
2017 Volume.52 No. 4 p.276 ~ p.284
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Relevance of prognostic index with β2-microglobulin for patients with diffuse large B-cell lymphoma in the rituximab era
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Kang Ji-Hoon
Yoon Shin-Kyo
Suh Cheol-Won
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Abstract
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Background: The International Prognostic Index (IPI) has been a useful tool for predicting the prognosis of aggressive non-Hodgkin lymphoma in the last 20 years. Herein, we aimed to develop a new prognostic model for diffuse large B-cell lymphoma (DLBCL) in the rituximab era.
Methods: Between March 2004 and June 2012, patients with DLBCL treated with rituximab, cyclo-phosphamide, doxorubicin, vincristine, and prednisolone chemotherapy regimen were identified in the database of the Asan Medical Center (AMC) Lymphoma Registry. The primary and secondary endpoints were a new prognostic index for DLBCL and validation of the National Comprehensive Cancer Network-International Prognostic Index in our cohort, respectively.
Results: The AMC cohort comprised 621 patients. The median follow-up duration was 43.3 months (range, 6.2?122.5 mo). Univariate analysis revealed that age (≤60 vs. ＞60 yr), lactate dehydrogenase (LDH; within normal vs. increased), Eastern Cooperative Oncology Group performance status (ECOG PS; 0 or 1 vs. ≥2), advanced stage (Ann Arbor stage I/II vs. III/IV), extra-nodal involvement (≤1 vs. ＞1), B symptoms (no vs. yes), and beta-2 microglobulin (β2MG, ≤2.5 vs. ＞2.5) can be used to predict overall survival (OS). In multivariate analysis, only age, LDH, ECOG performance status, and β2MG were significantly associated with OS, and we developed a new prognostic model with these 4 factors. The new prognostic model showed better discriminative power compared with the classic IPI.
Conclusion: Our new prognostic index model for DLBCL in the rituximab era has good discriminative power and is convenient to use.
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KEYWORD
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Diffuse large B-cell lymphoma, Prognostic index, NCCN-IPI, β2-microglobulin
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