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Published on: October 2, 2014
Central Nervous System International Prognostic Index Impacts Overall Survival in Diffuse Large B-cell Lymphoma
Rubén Solís-Armenta1, Bernardo Cacho-Díaz2, Olga Gutiérrez-Hernández3
1Department of Hematology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
Background:
Central nervous system international prognosis index (CNS-IPI) is validated in European and the USA cancer databases. However, no validation has been done in Mexican population.
Objective:
The objective of the study was to assess the impact of the CNS-IPI on central nervous system (CNS) relapse and survival in Mexican patients with diffuse large B-cell lymphoma (DLBCL).
Methods:
In this retrospective analysis, clinical, biochemical, and histological variables and the CNS-IPI were analyzed.
Results:
Six hundred and forty-two patients with DBLCL were included in the study. The mean ± SD age was 56.8 ± 14.9 years. Most had an ECOG of 0-1: 75% (n = 484) had absence of B-symptoms and advanced disease (clinical stage: III-IV, n = 433, 67.4%). According to the CNS-IPI, almost one-half were in the low-risk category. According to the CNS-IPI, CNS relapse rate was 1.36% (95% CI: 83.2-92.8), 3.1% (95% CI: 132.4-162.8), and 7.4% (95% CI 61-91) for patients in the low-, intermediate-, and high-risk categories, respectively. The median overall survival in the high-risk group (CNS-IPI) was 22 months, and it has not been achieved after 80 months of follow-up for the other groups.
Conclusions:
CNS-IPI was associated with survival; therefore, we propose its use as a prognostic tool for prospective validation.
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