Blood Res.  2015 Sep;50(3):160-166. 10.5045/br.2015.50.3.160.

Prediction of survival by applying current prognostic models in diffuse large B-cell lymphoma treated with R-CHOP followed by autologous transplantation

Affiliations
  • 1Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea. mlee@kuh.ac.kr
  • 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  • 3Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 4Department of Internal Medicine, The Catholic University of Korea College of Medicine, Suwon, Korea.
  • 5Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
  • 6Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea.
  • 7Department of Internal Medicine, Samsung Medical Center, Seoul, Korea.
  • 8Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
  • 9Department of Internal Medicine, National Cancer Center, Goyang, Korea.
  • 10Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 11Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
  • 12Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea.
  • 13Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 14Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea.

Abstract

BACKGROUND
Among the currently available prognostic models for diffuse large B-cell lymphoma (DLBCL), we investigated to determine which is most adoptable for DLBCL patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) followed by upfront autologous stem cell transplantation (auto-SCT).
METHODS
We retrospectively evaluated survival differences among risk groups based on the International Prognostic Index (IPI), the age-adjusted IPI (aaIPI), the revised IPI (R-IPI), and the National Comprehensive Cancer Network IPI (NCCN-IPI) at diagnosis in 63 CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT.
RESULTS
At the time of auto-SCT, 74.6% and 25.4% of patients had achieved complete remission and partial remission after R-CHOP, respectively. As a whole, the 5-year overall (OS) and progression-free survival (PFS) rates were 78.8% and 74.2%, respectively. The 5-year OS and PFS rates according to the IPI, aaIPI, R-IPI, and NCCN-IPI did not significantly differ among the risk groups for each prognostic model (P-values for OS: 0.255, 0.337, 0.881, and 0.803, respectively; P-values for PFS: 0.177, 0.904, 0.295, and 0.609, respectively).
CONCLUSION
There was no ideal prognostic model among those currently available for CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT.

Keyword

Diffuse large B-cell lymphoma; Hematopoietic stem cell transplantation; Autologous transplantation; Rituximab; Prognostic groups

MeSH Terms

Autografts*
B-Lymphocytes*
Cyclophosphamide
Diagnosis
Disease-Free Survival
Doxorubicin
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, B-Cell*
Prednisone
Retrospective Studies
Stem Cell Transplantation
Transplantation, Autologous*
Vincristine
Rituximab
Cyclophosphamide
Doxorubicin
Prednisone
Vincristine

Figure

  • Fig. 1 Probability of overall survival (OS) (A) and progression-free survival (PFS) (B) after autologous stem cell transplantation according to the International Prognostic Index (IPI) score at diagnosis.

  • Fig. 2 Probability of overall survival (OS) (A) and progression-free survival (PFS) (B) after autologous stem cell transplantation according to the age-adjusted International Prognostic Index (aaIPI) score at diagnosis.

  • Fig. 3 Probability of overall survival (OS) (A) and progression-free survival (PFS) (B) after autologous stem cell transplantation according to the revised International Prognostic Index (R-IPI) score at diagnosis.

  • Fig. 4 Probability of overall survival (OS) (A) and progression-free survival (PFS) (B) after autologous stem cell transplantation according to the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) score at diagnosis.


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