Yang Yan, Wang Lanlan, Ma Yanna, Han Tingting, Huang Mei
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Am J Med Sci. 2017 May;353(5):459-465. doi: 10.1016/j.amjms.2017.02.002. Epub 2017 Feb 8.
To explore the prognostic value of the enhanced International Prognostic Index (NCCN-IPI) for Asian patients with diffuse large B-cell lymphoma (DLBCL) treated in the rituximab era.
We performed a retrospective analysis of 176 patients with newly diagnosed DLBCL. The estimated overall survival (OS) and progression-free survival (PFS) of the different risk groups were discriminated by the International Prognostic Index (IPI), the revised International Prognostic Index (R-IPI) and the NCCN-IPI.
With a median follow-up of 18 months, at 3 years, the OS was 73% and the PFS was 65%. The 3-year OS for the 4 NCCN-IPI risk groups were 91% versus 80% versus 57% versus 45% (P < 0.001); the 3-year PFS were 77% versus 72% versus 56% versus 26% (P < 0.001). The 3-year OS of the 4 risk groups discriminated by the IPI ranged from 85-55% (P < 0.001); the 3-year PFS ranged from 81-41% (P < 0.001). The 3-year OS of the 3 distinct prognostic groups by the R-IPI ranged from 86-51% (P < 0.001); the 3-year PFS ranged from 86-47% (P < 0.001). The 3-year OS and PFS of the high-risk group according to the NCCN-IPI were lower than the IPI and R-IPI. Using the NCCN-IPI, the outcomes among the risk groups spanned a large range, and the survival of the high-risk group was significantly different from the high-intermediate risk group.
The NCCN-IPI is a clinically useful prognostic index for patients with DLBCL treated in the rituximab era, especially for high-risk patients.
探讨强化国际预后指数（NCCN-IPI）对利妥昔单抗时代接受治疗的亚洲弥漫性大B细胞淋巴瘤（DLBCL）患者的预后价值。
我们对176例新诊断的DLBCL患者进行了回顾性分析。通过国际预后指数（IPI）、修订后的国际预后指数（R-IPI）和NCCN-IPI区分不同风险组的估计总生存期（OS）和无进展生存期（PFS）。
中位随访18个月，3年时，OS为73%，PFS为65%。4个NCCN-IPI风险组的3年OS分别为91%对80%对57%对45%（P<0.001）；3年PFS分别为77%对72%对56%对26%（P<0.001）。IPI区分的4个风险组的3年OS为85%-55%（P<0.001）；3年PFS为81%-41%（P<0.001）。R-IPI区分的3个不同预后组的3年OS为86%-51%（P<0.001）；3年PFS为86%-47%（P<0.001）。根据NCCN-IPI，高危组的3年OS和PFS低于IPI和R-IPI。使用NCCN-IPI，风险组之间的结果差异很大，高危组的生存率与高中危组有显著差异。
NCCN-IPI是利妥昔单抗时代DLBCL患者临床有用的预后指标，尤其是对高危患者。
