Prognostic indices in diffuse large B-cell lymphoma in the rituximab era: an analysis of the UK National Cancer Research Institute R-CHOP 14 versus 21 phase 3 trial.


Journal

British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544

Informations de publication

Date de publication:
03 2021
Historique:
received: 14 01 2020
accepted: 05 04 2020
pubmed: 22 5 2020
medline: 3 8 2021
entrez: 22 5 2020
Statut: ppublish

Résumé

We compared the International Prognostic Index (IPI), Revised (R)-IPI and age-adjusted (aa)-IPI as prognostic indices for patients with diffuse large B-cell lymphoma (DLBCL) in the UK National Cancer Research Institute (NCRI) R-CHOP 14 versus 21 trial (N = 1080). The R-IPI and aa-IPI showed no marked improvement compared to the IPI for overall and progression-free survival, in terms of model fit or discrimination. Similar results were observed in exploratory analyses incorporating the Grupo Español de Linfomas/Transplante de Médula Ósea (GELTAMO)-IPI, where baseline β2-microglobulin data were available (N = 655). Although our findings support current use of the IPI, a novel prognostic tool to better delineate a high-risk DLBCL group in the rituximab era is needed.

Identifiants

pubmed: 32436212
doi: 10.1111/bjh.16691
doi:

Substances chimiques

R-CHOP protocol 0
Rituximab 4F4X42SYQ6
Vincristine 5J49Q6B70F
Doxorubicin 80168379AG
Cyclophosphamide 8N3DW7272P
Prednisone VB0R961HZT

Types de publication

Clinical Trial, Phase III Comparative Study Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1015-1019

Subventions

Organisme : Chugai Pharmaceutical
Organisme : National Institute for Health Research
Organisme : Cancer Research UK
Pays : United Kingdom

Informations de copyright

© 2020 British Society for Haematology and John Wiley & Sons Ltd.

Références

International Non-Hodgkin’s Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med. 1993;329:987-94.
Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007;109:1857-61.
Ziepert M, Hasenclever D, Kuhnt E, Glass B, Schmitz N, Pfreundschuh M, et al. Standard international prognostic index remains a valid predictor of outcome for patients with aggressive CD20 + B-cell lymphoma in the rituximab era. J Clin Oncol. 2010;28:2373-80.
Zhou Z, Sehn LH, Rademaker AW, Gordon LI, Lacasce AS, Crosby-Thompson A, et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood. 2014;123:837-42.
Melchardt T, Troppan K, Weiss L, Hufnagl C, Neureiter D, Tränkenschuh W, et al. A modified scoring of the NCCN-IPI is more accurate in the elderly and is improved by albumin and β2 -microglobulin. Br J Haematol. 2015;168:239-45.
El-Galaly TC, Villa D, Alzahrani M, Hansen JW, Sehn LH, Wilson D, et al. Outcome prediction by extranodal involvement, IPI, R-IPI, and NCCN-IPI in the PET/CT and rituximab era: a Danish-Canadian study of 443 patients with diffuse-large B-cell lymphoma. Am J Hematol. 2015;90:1041-6.
Bishton MJ, Hughes S, Richardson F, James E, Bessell E, Sovani V, et al. Delineating outcomes of patients with diffuse large b cell lymphoma using the national comprehensive cancer network-international prognostic index and positron emission tomography-defined remission status; a population-based analysis. Br J Haematol. 2016;172:246-54.
Nakaya A, Fujita S, Satake A, Nakanishi T, Azuma Y, Tsubokura Y, et al. Enhanced international prognostic index in Japanese patients with diffuse large B-cell lymphoma. Leuk Res Rep. 2016;6:24-6.
Montalbán C, Díaz-López A, Dlouhy I, Rovira J, Lopez-Guillermo A, Alonso S, et al. Validation of the NCCN-IPI for diffuse large B-cell lymphoma (DLBCL): the addition of β 2 -microglobulin yields a more accurate GELTAMO-IPI. Br J Haematol. 2017;176:918-28.
Cunningham D, Hawkes EA, Jack A, Qian W, Smith P, Mouncey P, et al. Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone in patients with newly diagnosed diffuse large B-cell non-Hodgkin lymphoma: a phase 3 comparison of dose intensification with 14-day versus 21-day cycles. Lancet. 2013;381:1817-26.

Auteurs

Mary Gleeson (M)

The Royal Marsden Hospital, London and Surrey, London, UK.
Guy's and St Thomas' NHS Foundation Trust, London, UK.

Nicholas Counsell (N)

Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK.

David Cunningham (D)

The Royal Marsden Hospital, London and Surrey, London, UK.

Anthony Lawrie (A)

Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK.

Laura Clifton-Hadley (L)

Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK.

Eliza Hawkes (E)

Department of Oncology and Clinical Haematology, Austin Health, Heidelberg, Melbourne, Australia.
Eastern Health, Melbourne, Australia.

Andrew McMillan (A)

Nottingham City Hospital, Nottingham, UK.

Kirit M Ardeshna (KM)

University College London, London, UK.
Mount Vernon Cancer Centre, Northwood, UK.

Cathy Burton (C)

HMDS, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Nick Chadwick (N)

Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK.

Joanna Gambell (J)

Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK.

Paul Smith (P)

Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK.

Paul Mouncey (P)

Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK.

Christopher Pocock (C)

East Kent Hospitals, Canterbury, UK.

John Radford (J)

The University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

John Davies (J)

Western General Hospital, Edinburgh, UK.

Deborah Turner (D)

Torbay Hospital, Torquay, UK.

Anton Kruger (A)

Royal Cornwall Hospital, Truro, UK.

Peter Johnson (P)

Cancer Research UK Centre, Southampton, UK.

David Linch (D)

University College London, London, UK.

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