Yonsei Med J.  2014 Nov;55(6):1568-1575. 10.3349/ymj.2014.55.6.1568.

The Modified Glasgow Prognostic Scores as a Predictor in Diffuse Large B Cell Lymphoma Treated with R-CHOP Regimen

• Kim Y
• Kim SJ
• Hwang D
• Jang J
• Hyun SY
• Kim YR
• Kim JS
• Min YH
• Cheong JW

• KMID: 2070204
• DOI: http://doi.org/10.3349/ymj.2014.55.6.1568

Abstract

PURPOSE
The modified Glasgow Prognostic Score (mGPS) consisting of serum C-reactive protein and albumin levels, shows significant prognostic value in several types of tumors. We evaluated the prognostic significance of mGPS in 285 patients with diffuse large B cell lymphoma (DLBCL), retrospectively.
MATERIALS AND METHODS
According to mGPS classification, 204 patients (71.5%) had an mGPS of 0, 57 (20%) had an mGPS of 1, and 24 (8.5%) had an mGPS of 2.
RESULTS
Our study found that high mGPS were associated with poor prognostic factors including older age, extranodal involvement, advanced disease stage, unfavorable International Prognostic Index scores, and the presence of B symptoms. The complete response (CR) rate after 3 cycles of R-CHOP chemotherapy was higher in patients with mGPS of 0 (53.8%) compared to those with mGPS of 1 (33.3%) or 2 (25.0%) (p=0.001). Patients with mGPS of 0 had significantly better overall survival (OS) than those with mGPS=1 and those with mGPS=2 (p=0.036). Multivariate analyses revealed that the GPS score was a prognostic factor for the CR rate of 3 cycle R-CHOP therapy (p=0.044) as well as OS (p=0.037).
CONCLUSION
mGPS can be considered a potential prognostic factor that may predict early responses to R-CHOP therapy in DLBCL patients.

Keyword

Modified Glasgow Prognostic Score; diffuse large B cell lymphoma; prognostic factor

MeSH Terms

Adult
Aged
Antibodies, Monoclonal, Murine-Derived/therapeutic use
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
C-Reactive Protein/*metabolism
Cyclophosphamide/therapeutic use
Doxorubicin/therapeutic use
Female
Glasgow Outcome Scale
Humans
Lymphoma, Large B-Cell, Diffuse/blood/*diagnosis/*drug therapy/mortality
Male
Middle Aged
Multivariate Analysis
Prednisone/therapeutic use
Prognosis
Remission Induction
Retrospective Studies
Serum Albumin/*metabolism
Survival Rate
Treatment Outcome
Vincristine/therapeutic use
Antibodies, Monoclonal, Murine-Derived
C-Reactive Protein
Cyclophosphamide
Doxorubicin
Serum Albumin
Prednisone
Vincristine

Figure

• 

  Fig. 1 Kaplan-Meier curves of overall survival and progression-free survival comparisons. (A) Overall survival and (B) progression-free survival according to mGPS levels in DLBCL patients treated with the R-CHOP regimen. mGPS, modified Glasgow Prognostic Score; DLBCL, diffuse large B cell lymphoma.

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