Evaluation of the MD Anderson tumor score for diffuse large B-cell lymphoma in the rituximab era
Por:
Gutierrez, A, Bento, L, Diaz-Lopez, A, Barranco, G, Garcia-Recio, M, Lopez-Guillermo, A, Dlouhy, I, Rovira, J, Rodriguez, M, Pina, JMS, Baile, M, Martn, A, Novelli, S, Sancho, JM, Garca, O, Salar, A, Bastos-Oreiro, M, Rodriguez-Salazar, MJ, Fernandez, R, de la Cruz, F, Queizan, JA, de Villambrosia, SG, Cordoba, R, Lpez, A, Luzardo, H, Garca, D, Sastre-Serra, J, Garcia, JF, Montalban, C, Cabanillas, F, Rodrguez, J
Publicada:
1 may 2020
Ahead of Print:
1 feb 2020
Resumen:
Objectives Diffuse large B-cell lymphoma (DLBCL) is an aggressive heterogeneous lymphoma with standard treatment. However, 30%-40% of patients still fail, so we should know which patients are candidates for alternative therapies. IPI is the main prognostic score but, in the rituximab era, it cannot identify a very high-risk (HR) subset. The MD Anderson Cancer Center reported a score in the prerituximab era exclusively considering tumor-related variables: Tumor Score (TS). We aim to validate TS in the rituximab era and to analyze its current potential role.
Methods From GELTAMO DLBCL registry, we selected those patients homogeneously treated with R-CHOP (n = 1327).
Results Five-years PFS and OS were 62% and 74%. All variables retained an independent prognostic role in the revised TS (R-TS), identifying four different risk groups, with 5-years PFS of 86%, 71%, 50%, and very HR (28%). With a further categorization of three variables of the original TS (Ann Arbor Stage, LDH and B2M), we generated a new index that allowed an improvement in HR assessment.
Conclusions (a) All variables of the original TS retain an independent prognostic role, and R-TS remains predictive in the rituximab era; (b) R-TS and additional categorization of LDH, B2M, and AA stage (enhanced TS) increased the ability to identify HR subsets.
Filiaciones:
Gutierrez, A:
Hosp Univ Son Espases, Lymphoma Unit, Dept Hematol, IdISBa, Palma De Mallorca, Spain
Bento, L:
Hosp Univ Son Espases, Lymphoma Unit, Dept Hematol, IdISBa, Palma De Mallorca, Spain
Diaz-Lopez, A:
MD Anderson Canc Ctr, Dept Translat Res, C Arturo Soria 270, Madrid, Spain
Barranco, G:
MD Anderson Canc Ctr, Dept Translat Res, C Arturo Soria 270, Madrid, Spain
Garcia-Recio, M:
Hosp Univ Son Espases, Lymphoma Unit, Dept Hematol, IdISBa, Palma De Mallorca, Spain
Lopez-Guillermo, A:
Hosp Clin Barcelona, Barcelona, Spain
Dlouhy, I:
Hosp Clin Barcelona, Barcelona, Spain
Rovira, J:
Hosp Clin Barcelona, Barcelona, Spain
Rodriguez, M:
Hosp Univ 12 Octubre, Madrid, Spain
Pina, JMS:
Hosp Univ 12 Octubre, Madrid, Spain
Baile, M:
Hosp Clin Univ Salamanca CAUSA, IBSAL, Salamanca, Spain
Martn, A:
Hosp Clin Univ Salamanca CAUSA, IBSAL, Salamanca, Spain
Novelli, S:
Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain
Sancho, JM:
Hosp Badalona Germans Trias & Pujol, Barcelona, Spain
Garca, O:
Hosp Badalona Germans Trias & Pujol, Barcelona, Spain
Salar, A:
Hosp del Mar, Dept Hematol, Barcelona, Spain
Bastos-Oreiro, M:
Gregorio Maranon Gen Univ Hosp HGUGM, Dept Hematol, Madrid, Spain
Rodriguez-Salazar, MJ:
Hosp Univ Canarias, Santa Cruz De Tenerife, Spain
Fernandez, R:
Hosp Cabuenes, Dept Hematol, Gijon, Spain
de la Cruz, F:
Hosp Virgen del Rocio, Dept Hematol, Seville, Spain
Queizan, JA:
Hosp Gen Segovia, Segovia, Spain
de Villambrosia, SG:
Hosp Univ Marques de Valdecilla, Dept Hematol, Santander, Spain
Cordoba, R:
Fdn Jimenez Diaz, Dept Hematol, Madrid, Spain
Lpez, A:
Hosp Valle De Hebron, Barcelona, Spain
Luzardo, H:
Hosp Dr Negrin, Madrid, Spain
Garca, D:
Hosp Zarzuela, Madrid, Spain
Sastre-Serra, J:
IUNICS, Grp Multidisciplinar Oncol Traslac, Palma De Mallorca, Spain
Garcia, JF:
MD Anderson Canc Ctr, Dept Translat Res, C Arturo Soria 270, Madrid, Spain
MD Anderson Canc Ctr, Dept Pathol, Madrid, Spain
Montalban, C:
MD Anderson Canc Ctr, Dept Translat Res, C Arturo Soria 270, Madrid, Spain
Cabanillas, F:
Auxilio Mutuo Canc Ctr, San Juan, Spain
Rodrguez, J:
MD Anderson Canc Ctr, Dept Translat Res, C Arturo Soria 270, Madrid, Spain
Green Published, Hybrid Gold
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