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Poster display session

2811 - Evaluation of various prognostic scores and impact of cell of origin on survival in Limited stage DLBCL: Retrospective study.

Date

09 Sep 2017

Session

Poster display session

Presenters

Muhammad Rauf

Citation

Annals of Oncology (2017) 28 (suppl_5): v355-v371. 10.1093/annonc/mdx373

Authors

M.S. Rauf, S. Akhtar, T. Ahmed M. Elhassan, Q. Shaikh, F. A. Almugbel, M. N. Zahir, N. Bakshi, I. Maghfoor

Author affiliations

  • Medical Oncology, King Faisal Specialist Hospital and Research Center, 11211 - Riyadh/SA
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Resources

Abstract 2811

Background

Utility of International Prognostic Index (IPI) as standard prognostic tool in limited stage diffuse large B-cell lymphoma (Li DLBCL) has been controversial. Variety of other prognostic scores have been proposed including Miller’s stage modified IPI (M-IPI), NCCN-IPI (N-IPI), and stage adjusted IPI (St-IPI). We aimed to compare various prognostic scores. In addition, data is not clear regarding impact of cell of origin (COO) i.e. Germinal Center (GCB) and non-GCB COO in patients with Li DLBCL. Our aim is to identify difference in outcomes by COO.

Methods

All patients with newly diagnosed non-bulky Li DLBCL treated with standard first line CHOP±R chemotherapy with or without radiation from 1987 to 2013 were eligible. Discrimination ability of each prognostic model was also tested using bagging model. Model performance was evaluated using sensitivity, accuracy and Area under the Receiver Operating Characteristic Curve (AUC) and model which scored highest AUC, was selected. Survival times and survival proportions were estimated using the Kaplan Meier survival curves. In addition, we applied Hans’s algorithm to study prognostic impact of COO.

Results

The median age of the 276 included patients was 47 years. 32% received limited combine modality treatment while 68% patients received extensive chemotherapy. Median follow up was 4.9 years. M-IPI was the best prognostic indicator of both PFS (AUC=0.67) and OS (AUC=0.72) when compared with IPI, N-IPI and St-IPI. Immunohistochemistry data of 152 patients treated homogeneously was available to determine COO. GCB phenotype seen in 61%. There was no significant difference in PFS (p = 0.6) or OS (p = 0.4).Table:

1014P Comparison of prognostic models for Li DLBCL

Risk modelSensitivityF-statisticalAUC
PFSOSPFSOSPFSOS
St-IPI0.920.910.690.680.590.58
IPI0.470.510.570.600.610.64
N-IPI0.810.840.660.680.580.6
M- IPI0.730.60.680.640.670.72

Conclusions

Our data identified that in limited stage non-bulky DLBCL, M-IPI is more robust tool for outcome prediction with better power for risk stratification in the CHOP±R as compare to other prognostic models. There was no significant difference in PFS or OS for patients in the GCB and non-GCB limited stage non-bulky DLBCL.

Clinical trial identification

none

Legal entity responsible for the study

Oncology Center, King Faisal Specialist Hospital and Research Center

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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