1069PD - Predicting response rates of high grade non Hodgkin's lymphoma: a comparative study of international prognostic index (IPI) with subjective global a...

Date 01 October 2012
Event ESMO Congress 2012
Session Hematological malignancies
Topics Lymphomas
Presenter Vikas Ostwal
Authors V.S. Ostwal1, P. Bagayatkar2, P. Pawaskar3, R. Thippeswamy4, M. Sengar3, H. Menon3, N. Khattry3, B. Bagal3, R. Nair1, M.K. Mallath5
  • 1Tata Memorial Hospital Centre, IN-400012 - Mumbai/IN
  • 2Medical Oncology, Tata Memorial Hospital, Mumbai/IN
  • 3Medical Oncology, Tata Memorial Hospital Centre, 400012 - Mumbai/IN
  • 4Medical Oncology, Tata Memorial Hospital Centre, IN-400012 - Mumbai/IN
  • 5Digestive Diseases, Tata Memorial Hospital Centre, 400012 - Mumbai/IN

Abstract

Introduction

Malnutrition is common in patients with cancer and no study has co- related the effect of malnutrition on outcomes of non Hodgkins Lymphoma (NHL) from India. Besides, there are no studies validating the international prognostic index (IPI) from India. This study was done to compare the prognostic abilities of IPI and subjective global assessment (SGA) for early outcomes in NHL.

Methods

This is a prospective observational study set in the lymphoma clinic of Tata Memorial Hospital, Mumbai between January to December 2010. All patients were screened for malnutrition at entry using a modified SGA tool. Baseline clinical factors of prognostic importance including IPI scores were recorded. Univariate and multivariate comparison were made using SPSS or EpiInfo 2000 software.

Results

There were 401 patients with high grade NHL. The analysis of 389 patients with all information available showed that the IPI scores were low risk, low intermediate risk, intermediate high risk, high risk in 133 (34.3%), 95 (24.4 %), 91 (23.4%) and 70 (17.9 %) patients respectively. The SGA scores were A, B, and C in 188 (48.6%), 129 (33.2%) and 72 (18.2 %) patients respectively. Early outcomes included CR in 241 (62.6 %), EFS in 73% and overall survival in 81% patients at 1-year. Univariate analysis revealed that the SGA scores were significantly associated with the IPI variables - age, serum LDH, performance status (ECOG), stage (Ann Arbor), extranodal sites as well as hemoglobin, response rates, one year survival and disease progression. Multivariate analysis revealed that SGA was a highly significant independent predictor of all early outcome parameters. Some IPI scores lost significance in the multivariate model.

Conclusions

The SGA is a highly significant and independent predictive biomarker (for CR) and a prognostic biomarker (for 1-year OS and PFS) with good discriminative function in patients with NHL.

Disclosure

All authors have declared no conflicts of interest.