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The Enhanced International Prognostic Index for Diffuse Large B-cell Lymphoma
Yan Yang1, Lanlan Wang1, Yanna Ma1
1Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Objective:
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.
Materials And Methods:
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.
Results:
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.
Conclusions:
The NCCN-IPI is a clinically useful prognostic index for patients with DLBCL treated in the rituximab era, especially for high-risk patients.
