Hong Junshik, Kim Seok Jin, Chang Myung Hee, Kim Jeong-A, Kwak Jae-Yong, Kim Jin Seok, Yoon Dok Hyun, Lee Won Sik, Do Young Rok, Kang Hye Jin, Eom Hyeon-Seok, Park Yong, Won Jong-Ho, Mun Yeung-Chul, Kim Hyo Jung, Kwon Jung Hye, Kong Jee Hyun, Oh Sung Yong, Lee Sunah, Bae Sung Hwa, Yang Deok-Hwan, Jun Hyun Jung, Lee Ho Sup, Yun Hwan Jung, Lee Soon Il, Kim Min Kyoung, Yi Jun Ho, Lee Jae Hoon, Kim Won Seog, Suh Cheolwon
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Oncotarget. 2017 Sep 18;8(54):92171-92182. doi: 10.18632/oncotarget.20988. eCollection 2017 Nov 3.
The National Comprehensive Cancer Network (NCCN)-International Prognostic Index (IPI) and GELTAMO (Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea)-IPI were developed to enable better risk prediction of patients with diffuse large B-cell lymphoma (DLBCL). The present study compared the effectiveness of risk prediction between IPI, NCCN-IPI, and GELTAMO-IPI in patients with DLBCL particularly in terms of determining high-risk patients. Among 439 patients who were enrolled to a prospective DLBCL cohort treated with R-CHOP immunochemotherapy, risk groups were classified according to the three IPIs and the prognostic significance of individual IPI factors and IPI models were analyzed and compared. All three IPI effectively separated the analyzed patients into four risk groups according to overall survival (OS). Estimated 5-year OS of patients classified as high-risk according to the IPI was 45.7%, suggesting that the IPI is limited in the selection of patients who are expected to have a poor outcome. In contrast, the 5-year OS of patients stratified as high-risk according to NCCN- and GELTAMO-IPI was 31.4% and 21.9%, respectively. The results indicate that NCCN- and GELTAMO-IPI are better than the IPI in predicting patients with poor prognosis, suggesting the superiority of enhanced, next-generation IPIs for DLBCL.
美国国立综合癌症网络（NCCN）国际预后指数（IPI）和西班牙淋巴瘤/自体骨髓移植研究组（GELTAMO）-IPI旨在更准确地预测弥漫性大B细胞淋巴瘤（DLBCL）患者的风险。本研究比较了IPI、NCCN-IPI和GELTAMO-IPI在DLBCL患者风险预测方面的有效性，特别是在确定高危患者方面。在439例接受R-CHOP免疫化疗的前瞻性DLBCL队列患者中，根据三种IPI对风险组进行分类，并分析和比较各IPI因素及IPI模型的预后意义。所有三种IPI均能根据总生存期（OS）有效地将分析患者分为四个风险组。根据IPI分类为高危的患者估计5年OS为45.7%，这表明IPI在选择预后不良患者方面存在局限性。相比之下，根据NCCN-IPI和GELTAMO-IPI分层为高危的患者5年OS分别为31.4%和21.9%。结果表明，NCCN-IPI和GELTAMO-IPI在预测预后不良患者方面优于IPI，提示增强型下一代IPI对DLBCL具有优越性。
