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@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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