Open AccessSIL index, comprising stage, soluble interleukin‐2 receptor, and lactate dehydrogenase, is a useful prognostic predictor in diffuse large B ‐cell lymphoma
Author(s) -
Tomita Naoto,
Sakai Rika,
Fujisawa Shin,
Fujimaki Katsumichi,
Taguchi Jun,
Hashimoto Chizuko,
Ogawa Koji,
Yamazaki Etsuko,
Ishigatsubo Yoshiaki
Publication year - 2012
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/j.1349-7006.2012.02331.x
Subject(s) - international prognostic index , rituximab , diffuse large b cell lymphoma , medicine , vincristine , chop , lactate dehydrogenase , cyclophosphamide , lymphoma , oncology , gastroenterology , prednisolone , chemotherapy , biology , biochemistry , enzyme
Rituximab ( R ) plus doxorubicin, cyclophosphamide, vincristine, and prednisolone ( CHOP ) chemotherapy ( R ‐ CHOP ) is widely accepted as standard care for diffuse large B ‐cell lymphoma ( DLBCL ) patients. The revised I nternational P rognostic Index ( R ‐ IPI ) was established in 2007 after the addition of rituximab to standard DLBCL treatment. To reassess the utility of R ‐ IPI , we carried out a retrospective analysis of patients with DLBCL uniformly treated with standard R ‐ CHOP . Progression‐free survival ( PFS ) curves in “very good” and “good” risk groups as defined by the R ‐ IPI showed no statistical difference. We added soluble interleukin‐2 receptor (s IL ‐2 R ) level to the factors comprising the R ‐ IPI . Five levels of s IL ‐2 R were weighed with respect to their impact on PFS . s IL ‐2 R of >2500 U/mL was determined as the most appropriate threshold. We developed a new prognostic SIL index, which includes three independent prognostic risk factors: clinical stage ( S ); s IL ‐2 R level over 2500 U/mL ( I ); and elevated lactate dehydrogenase level ( L ). This index indicates standard risk (0 or 1 risk factors, 4‐year PFS 83%, 4‐year overall survival 91%) and high risk (2 or 3 risk factors, 4‐year PFS 52%, 4‐year overall survival 67%) outcomes. The SIL index is a simple and objective prognostic index for DLBCL patients to identify candidates for experimental therapy other than R ‐ CHOP . ( Cancer Sci , doi: 10.1111/j.1349‐7006.2012.02331.x, 2012)