Evaluation of prognostic values of clinical and histopathologic characteristics in diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy

Departments of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Korea.
Leukemia & lymphoma (Impact Factor: 2.89). 06/2011; 52(10):1904-12. DOI: 10.3109/10428194.2011.588761
Source: PubMed

ABSTRACT The relationship between histopathologic characteristics and treatment outcomes in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-based immunochemotherapy needs re-evaluation. Patients with newly diagnosed DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) were evaluated with respect to clinical characteristics, treatment efficacy, and survival. Immunohistochemistry of bcl-2, CD10, bcl-6, and MUM-1 was performed and patients were sub-classified as germinal center B-cell-like (GCB) or non-GCB type according to the Hans algorithm. There was no significant difference in overall survival (OS) between patients with GCB and those with non-GCB. Although there was no significant difference in OS between high-intermediate and high risk groups as classified by the standard International Prognostic Index (IPI; p = 0.50), all three groups with the revised IPI had a clear-cut separation for event-free survival and OS. The revised IPI better predicted survival than did the standard IPI in patients with DLBCL treated with R-CHOP. The Hans classification had no prognostic value.

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    • "Diffuse large B-cell lymphoma (DLBCL) represents 30–40% of newly diagnosed adult Non-Hodgkin lymphomas (NHL), and is a heterogeneous group of disorders with variable histological and clinical behaviour (The Non-Hodgkin's Lymphoma Classification Project's, 1997; De Paepe & De Wolf-Peeters, 2007; Jaffe, 2009; Flowers et al, 2010; Nogai et al, 2011; Shenoy et al, 2011). Strong prognostic indicators of outcomes include the International Prognostic Index (IPI) and molecular and genomic markers (Rosenwald et al, 2002; Shipp et al, 2002; Gascoyne et al, 2010; Hong et al, 2011). "
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