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

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.

Basic information

Original name

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

Authors

PROCHÁZKA, Vít (203 Czech Republic); Robert PYTLÍK (203 Czech Republic); Andrea JANÍKOVÁ (203 Czech Republic, guarantor, belonging to the institution); David BELADA (203 Czech Republic); David ŠÁLEK (203 Czech Republic, belonging to the institution); Tomáš PAPAJÍK (203 Czech Republic); Vít CAMPR (203 Czech Republic); Tomáš FÜRST (203 Czech Republic); Jana FURSTOVA (203 Czech Republic) and Marek TRNĚNÝ (203 Czech Republic)

Edition

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

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

is not subject to a state or trade secret

Impact factor

Impact factor: 3.234

RIV identification code

RIV/00216224:14110/14:00080009

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1371/journal.pone.0102594

UT WoS

000341354800028

EID Scopus

2-s2.0-84904803452

Keywords in English

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

Abstract

In the original language

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.

Cite

PROCHÁZKA, Vít; Robert PYTLÍK; Andrea JANÍKOVÁ; David BELADA; David ŠÁLEK; Tomáš PAPAJÍK; Vít CAMPR; Tomáš FÜRST; Jana FURSTOVA and Marek TRNĚNÝ. 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. Plos one. San Francisco: Public Library Science, 2014, vol. 9, No 7, p. 1-10. ISSN 1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0102594.

@article{1297252,
   author = {Procházka, Vít and Pytlík, Robert and Janíková, Andrea and Belada, David and Šálek, David and Papajík, Tomáš and Campr, Vít and Fürst, Tomáš and Furstova, Jana and Trněný, Marek},
   article_location = {San Francisco},
   article_number = {7},
   doi = {http://dx.doi.org/10.1371/journal.pone.0102594},
   keywords = {NON-HODGKINS-LYMPHOMA; ABSOLUTE LYMPHOCYTE; PATIENTS OLDER; RITUXIMAB ERA; TRIAL; CHEMOTHERAPY; SURVIVAL; SUBTYPE; MARKER; IPI},
   language = {eng},
   issn = {1932-6203},
   journal = {Plos one},
   title = {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},
   volume = {9},
   year = {2014}
}

TY  - JOUR
ID  - 1297252
AU  - Procházka, Vít - Pytlík, Robert - Janíková, Andrea - Belada, David - Šálek, David - Papajík, Tomáš - Campr, Vít - Fürst, Tomáš - Furstova, Jana - Trněný, Marek
PY  - 2014
TI  - 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
JF  - Plos one
VL  - 9
IS  - 7
SP  - 1-10
EP  - 1-10
PB  - Public Library Science
SN  - 19326203
KW  - NON-HODGKINS-LYMPHOMA
KW  - ABSOLUTE LYMPHOCYTE
KW  - PATIENTS OLDER
KW  - RITUXIMAB ERA
KW  - TRIAL
KW  - CHEMOTHERAPY
KW  - SURVIVAL
KW  - SUBTYPE
KW  - MARKER
KW  - IPI
N2  - 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.
ER  -

PROCHÁZKA, Vít; Robert PYTLÍK; Andrea JANÍKOVÁ; David BELADA; David ŠÁLEK; Tomáš PAPAJÍK; Vít CAMPR; Tomáš FÜRST; Jana FURSTOVA and Marek TRNĚNÝ. 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. \textit{Plos one}. San Francisco: Public Library Science, 2014, vol.~9, No~7, p.~1-10. ISSN~1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0102594.

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