Prognostic factors in diffuse large B-cell lymphoma treated by risk-adopted therapy

Abstract

Objective: The International Prognostic Index (IPI) was reported in 1993 and it is now widely used for predicting the outcome in patients with aggressive non-Hodgkin's lymphoma. It defines 5 risk factors and 4 distinct risk groups from retrospective data. In this study, we evaluated the outcome of risk-adopted therapy for diffuse large B-cell lymphoma. (DLBCL), the most common aggressive lymphoma, and assessed the possible prognostic factors. Methods and Patients: We treated 177 consecutive patients newly diagnosed with DLBCL using therapies determined by putative risk factors. Therapies included CHOP followed by involved field irradiation; ACOMP-B with the consolidation regimen ML-Y9; high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation; or performance status (PS) oriented CHOP. Statistical analysis was performed to determine the comprehensive risk factors in DLBCL. Results: Overall, the complete response (CR), 3-year overall survival (OS), and 3-year relapse-free survival (RFS) rates for CR patients were 71%, 69%, and 75%, respectively. Male gender, high LDH, poor PS (≥2), more than one extranodal involvement site, and B symptoms were independent adverse prognostic factors for OS. High LDH and poor PS were independent, adverse prognostic factors for RFS. Conclusion; In the 5 risk factors indicated by IPI, high LDH and poor PS remained for OS and RFS even after risk-adopted therapy. © 2006 The Japanese Society of Internal Medicine.