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Clinical outcomes in patients with diffuse large B cell lymphoma with a partial response to first-line R-CHOP chemotherapy: prognostic value of secondary International Prognostic Index scores and Deauville scores

Authors
 Hyewon Lee  ;  Yu Ri Kim  ;  Soo-Jeong Kim  ;  Yong Park  ;  Hyeon-Seok Eom  ;  Sung Yong Oh  ;  Hyo Jung Kim  ;  Hye Jin Kang  ;  Won-Sik Lee  ;  Joon Ho Moon  ;  Young-Woong Won  ;  Tae-Sung Kim  ;  Jin Seok Kim 
Citation
 Annals of Hematology, Vol.96(11) : 1873-1881, 2017 
Journal Title
 Annals of Hematology 
ISSN
 0939-5555 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage* ; Cyclophosphamide/administration & dosage ; Doxorubicin/administration & dosage ; Female ; Humans ; Internationality ; Lymphoma, Large B-Cell, Diffuse/diagnosis* ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Lymphoma, Large B-Cell, Diffuse/mortality ; Male ; Middle Aged ; Prednisone/administration & dosage ; Prognosis ; Retrospective Studies ; Severity of Illness Index* ; Survival Rate/trends ; Treatment Outcome ; Vincristine/administration & dosage ; Young Adult
Keywords
Deauville scores ; Diffuse large B cell lymphoma ; FDG-PET ; International Prognostic Index ; Partial response
Abstract
After introducing a rituximab-containing chemoimmunotherapy (R-CHOP) for diffuse large B cell lymphoma (DLBCL), a partial response (PR) which is regarded as treatment failure is still observed. To investigate the prognostic factors for the DLBCL patients with a PR to R-CHOP, we retrospectively evaluated 758 newly diagnosed DLBCL patients. After R-CHOP, 88 (11.6%) achieved a PR. Three-year progression-free and overall survival rates measured from the date of PR achievement (PFS2 and OS2) were 57.4 and 67.8%, respectively. The secondary International Prognostic Index (IPI2) scores after R-CHOP were low (0-1) in 68.2% and high (2-3) in 31.8% of the patients. The Deauville scores from 18-fluorodeoxyglucose positron emission tomography after R-CHOP showed low (2-3) in 58.0% and high (4) in 42.0% of the patients. High IPI2 and high Deauville scores were associated with worse PFS2 (P < 0.001 and P = 0.009) and OS2 (P = 0.013 and P = 0.067). The high-risk group defined by the IPI2 and Deauville scores, whose scores were both high, showed significantly lower 3-year PFS2 (P < 0.001) and OS2 (P = 0.006) rates compared with those of the other groups. In multivariate analyses, the IPI score of ≥ 3 at diagnosis and bone marrow involvement at diagnosis were independent prognostic factors. In addition, high IPI2-Deauville score after R-CHOP was significantly associated with poor PFS2 (P = 0.009) and demonstrated a trend toward inferior OS2. In conclusion, DLBCL patients who partially responded to R-CHOP are still a heterogeneous group, for which IPI2 and Deauville scores should be evaluated for prediction of prognosis.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161073
DOI
10.1007/s00277-017-3107-6
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김수정(Kim, Soo Jeong) ; 김유리(Kim, Yu Ri) ; 김진석(Kim, Jin Seok)
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Full Text
https://link.springer.com/article/10.1007%2Fs00277-017-3107-6
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