Premium
Evaluation of the MD Anderson tumor score for diffuse large B‐cell lymphoma in the rituximab era
Author(s) -
Gutierrez Antonio,
Bento Leyre,
DiazLopez Antonio,
Barranco Gilberto,
GarciaRecio Marta,
LopezGuillermo Armando,
Dlouhy Ivan,
Rovira Jordina,
Rodriguez Mario,
Sanchez Pina Jose María,
Baile Monica,
Martín Alejandro,
Novelli Silvana,
Sancho JuanManuel,
García Olga,
Salar Antonio,
BastosOreiro Mariana,
RodriguezSalazar Mª José,
Fernandez Ruben,
Cruz Fatima,
Queizan Jose Antonio,
González de Villambrosia Sonia,
Cordoba Raul,
López Andres,
Luzardo Hugo,
García Daniel,
SastreSerra Jordi,
Garcia Juan Fernando,
Montalban Carlos,
Cabanillas Fernando,
Rodríguez Jose
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13364
Subject(s) - rituximab , diffuse large b cell lymphoma , medicine , lymphoma , international prognostic index , oncology , chop , stage (stratigraphy) , paleontology , biology
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.