J 2014

A New Prognostic Score for Elderly Patients with Diffuse Large B-Cell Lymphoma Treated with R-CHOP: The Prognostic Role of Blood Monocyte and Lymphocyte Counts Is Absent

PROCHÁZKA, Vít; Robert PYTLÍK; Andrea JANÍKOVÁ; David BELADA; David ŠÁLEK et al.

Základní údaje

Originální název

A New Prognostic Score for Elderly Patients with Diffuse Large B-Cell Lymphoma Treated with R-CHOP: The Prognostic Role of Blood Monocyte and Lymphocyte Counts Is Absent

Autoři

PROCHÁZKA, Vít; Robert PYTLÍK; Andrea JANÍKOVÁ; David BELADA; David ŠÁLEK; Tomáš PAPAJÍK; Vít CAMPR; Tomáš FÜRST; Jana FURSTOVA a Marek TRNĚNÝ

Vydání

Plos one, San Francisco, Public Library Science, 2014, 1932-6203

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 3.234

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/14:00080009

Organizační jednotka

Lékařská fakulta

EID Scopus

Klíčová slova anglicky

NON-HODGKINS-LYMPHOMA; ABSOLUTE LYMPHOCYTE; PATIENTS OLDER; RITUXIMAB ERA; TRIAL; CHEMOTHERAPY; SURVIVAL; SUBTYPE; MARKER; IPI

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 8. 4. 2015 11:46, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

Background: Absolute lymphocyte count (ALC) and absolute monocyte count (AMC) have been documented as independent predictors of survival in patients with newly diagnosed Diffuse Large B-cell Lymphoma (DLBCL). Analysis of the prognostic impact of ALC and AMC in the context of International Prognostic Index (IPI) and other significant variables in elderly population treated in the R-CHOP regime has not been carried out yet. Methodology/Principal Findings: In this retrospective study, a cohort of 443 newly diagnosed DLBCL patients with age >= 60 was analyzed. All patients were treated with the R-CHOP therapy. An extensive statistical analysis was performed to identify risk factors of 3-year overall survival (OS). In multivariate analysis, only three predictors proved significant: Eastern Cooperative Oncology Group performance status (ECOG), age and bulky disease presence. These predictors were dichotomized (ECOG >= 1, age >= 70, bulk >= 7.5) to create a novel four-level score. This score predicted 3-year OS of 94.0%, 77.4%, 62.7% and 35.4% in the low-, low-intermediate, high-intermediate and high-risk groups, respectively (P<0.001). Further, a three-level score was tested which stratifies the population better (3-year OS: 91.9%, 67.2%, 36.2% in the low, intermediate and high-risk groups, respectively) but is more difficult to interpret. Both the 3- and 4-level scores were compared to standard scoring systems and, in our population, were shown to be superior in terms of patients risk stratification with respect to 3-year OS prediction. The results were successfully validated on an independent cohort of 162 patients of similar group characteristics. Conclusions: The prognostic role of baseline ALC, AMC or their ratio (LMR) was not confirmed in the multivariate context in elderly population with DLBCL treated with R-CHOP. The newly proposed age-specific index stratifies the elderly population into risk groups more precisely than the conventional IPI and its existing variants.