Background: The addition of rituximab to CHOP chemotherapy (R-CHOP) has resulted in a marked improvement in outcome for patients with diffuse large B cell lymphoma (DLBCL). The previously estimated risk factors needed to be re-evaluated in immunochemotherapy era. Shen et al. (

Blood 109:1857–61, 2007
) reported that a revised (R) international prognostic index (IPI) provided a more clinically relevant prediction of outcome than IPI. To assess the applicability of IPI and R-IPI in unselected Korean DLBCL patients, we conducted this study.

Methods: We performed a retrospective analysis of patients with newly diagnosed DLBCL treated with R-CHOP to assess the value of the IPI and R-IPI.

Results: From January 2004 to July 2006, 113 newly diagnosed DLBCL patients from four Korean institutes were included. Patients characteristics were: median age 54 y (range: 14–83), male 62.8%, extranodal disease 54.9%, age greater than 60y 40.7%, ECOG PS greater than 2 10.6%, elevated LDH 46.9%, more than 1 extranodal sites 17.7%, stage III/IV 40.7%. The 3 year EFS rate was 60.2% and the 3 year OS rate was 66.7%. Estimated 3 year EFS and OS according to IPI were described in the table.

Conclusions: The IPI score as well as R-IPI was an important prognostic parameter in unselected Korean DLBCL patients treated with R-CHOP.

No of Pt3 year EFS (%)p-value3 year OS (%)p-value
No of IPI   <0.001  0.001 
0 22 78.6  83.3  
1 40 71.8  81.9  
2 28 59.3  61.8  
3 16 36.5  42.4  
4 6 16.7  22.8  
5 1 0  0  
IPI   <0.001  <0.001 
Low 62 74.7  82.8  
Low intermediate 28 79.3  61.8  
High intermediate 16 36.5  42.4  
High 7 14.3  16.7  
R-IPI   <0.001  0.008 
Very good 22 78.6  83.3  
Good 68 65.8  71.6  
Poor 23 28.1  34.9  
No of Pt3 year EFS (%)p-value3 year OS (%)p-value
No of IPI   <0.001  0.001 
0 22 78.6  83.3  
1 40 71.8  81.9  
2 28 59.3  61.8  
3 16 36.5  42.4  
4 6 16.7  22.8  
5 1 0  0  
IPI   <0.001  <0.001 
Low 62 74.7  82.8  
Low intermediate 28 79.3  61.8  
High intermediate 16 36.5  42.4  
High 7 14.3  16.7  
R-IPI   <0.001  0.008 
Very good 22 78.6  83.3  
Good 68 65.8  71.6  
Poor 23 28.1  34.9  
View Large

Topics:
diffuse large b-cell lymphoma, r-chop, extranodal disease, chemotherapy regimen, cyclophosphamide, doxorubicin, prednisone, and vincristine, electrocorticogram, rituximab, eastern cooperative oncology group

Author notes

Disclosure: No relevant conflicts of interest to declare.

2007, The American Society of Hematology
2007
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