Abstract 777P
Background
Diffuse large B cell lymphoma (DLBCL) is an aggressive lymphoma and the most important prognostic factor in predicting outcome is the Revised International Prognostic Index (R-IPI). In this study we looked at the significance of Glasgow prognostic score in patients with DLBCL.
Methods
This is a prospective study of 110 patients with newly diagnosed DLBCL, treated at Regional Cancer Centre Trivandrum with R-CHOP chemoimmunotherapy. The Glasgow prognostic score was calculated at baseline using CRP and Serum albumin, as follows: patients with both elevated CRP (≥10 mg/L) and low albumin (<3.5 g/dL) levels were allocated a score of 2, patients with either elevated CRP (≥10 mg/L) or low albumin (<3.5 g/dL) were allocated a score of 1, and those with normal CRP and albumin levels were allocated a score of 0. The baseline GPS distribution and its association with treatment response and survival were studied.
Results
This study included 110 patients with a median age of 55 years with a male-to-female ratio of 1:1.1. The Ann Arbor stage was I in 7.2%, II in 35.4%, III in 20%, and IV in 37.2% patients. The Revised International Prognostic Index (R-IPI) risk group was very good in 18.2%, good in 54.5%, and poor in 27.3% of patients. The baseline GPS score was zero in 59.3%, one in 22.7%, and two in 18% of patients. All patients received R-CHOP chemoimmunotherapy. The end of treatment PET-CT showed complete response in 86.3%, persistent disease in 7.3%, and progressive disease in 6.4%. GPS of one or two correlated with persistent or progressive disease and poor risk group of R-IPI (p<0.05). Progression-free survival at 18 months for GPS scores of zero, one, and two (96.4% vs 73.3% vs 58.3%)(p<0.001). Overall survival at 18 months for GPS scores of zero, one, and two were 98.8%, 93.3%, and 83.3% respectively (p<0.001).
Conclusions
This study demonstrated that a GPS score of one or two correlated with poor risk R-IPI, persistent or progressive disease, and inferior PFS and OS at 18 months compared with patients having a GPS score of zero. Hence GPS could act as a prognostic marker which could help categorize patients who have poor outcomes with standard chemoimmunotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
G. Narayanan.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.