Contributions
Abstract: EP563
Type: E-Poster Presentation
Session title: Aggressive Non-Hodgkin lymphoma - Clinical
Background
In recent years, different prognostic indices have been developed for diffuse large cell B-cell lymphoma (DLBCL) like the IPI, the R-IPI, the NCCN-IPI and, in our environment, the GELTAMO-IPI which is the only that includes the beta-2 microglobulin. Since the introduction of rituximab, an improvement in response rates and survival has been observed. Nevertheless, patients with an adverse clinical course continue to be observed and their identification is essential to assess alternative therapies
Aims
To analyze the reproducibility of prognostic indices for LBDCG in our serie of patients treated outside of clinical trials; and assess the capacity of the prognostic indices to detect in high-risk patients.
Methods
137 patients diagnosed with DLBCL between June 2004 and June 2020 were included. The treatment was R-CHOP or similar (39 with liposomal doxorrubicin and 5 with etoposide associated to treatment). Furthermore, 29 patients received a 2nd-line treatment, 7 of them with auto-HSCT. We analyzed the prognostic characteristics at diagnosis and the overall survival. We applied 4 prognostic indices: IPI, R-IPI, NCCN-IPI and GELTAMO-IPI.
Survival was studied using the Kaplan-Meyer method and the survival curves were compared with the Log-Rank test. The Cox method was used to calculate the Hazard ratio
Results
Table 1 shows the main prognostic characteristics at diagnosis in our group of patients. With a median follow-up of 25 months, the median overall survival was 120 months (95% CI 42-198). Table 2 shows the different prognostic indices depending on the risk group. In the table 3 we observe the 5-year overall survival, with significant differences in the Log-Rank test with all indexes. All prognostic indices have been significant for the correct distribution of patients according to the risk group, being the GELTAMO-IPI index the best to identify high-risk group patients.
TABLE 1: DATA AT DIAGNOSIS
Age: middle | Sex (M/F) | ECOG>2 | High LDH | Stage III/IV | High Beta-2 microglobulin |
66 (16-88) | 58/79 | 34(28%) | 90 (66%) | 88 (64%) | 63(45%) |
TABLE 2: PROGNOSTIC INDICES DISTRIBUTION BY RISK GROUP PATIENTS
IPI | R-IPI | NCCN-IPI | GELTAMO-IPI | |
LOW | 39 (28%) | 8 (6%) | 10 (7%) | 15 (11%) |
INTER-LOW | 31 (23%) | 62 (45%) | 48 (35%) | 81 (59%) |
INTER-HIGH | 29 (21%) | 52 (38%) | 32 (23%) | |
HIGH | 38 (28%) | 67 (49%) | 27 (20%) | 9 (7%) |
TABLE 3: 5-YEARS OVERALL SURVIVAL BY RISK GROUPS.
IPI | R-IPI | NCCN-IPI | GELTAMO-IPI | |
LOW | 0,82 (0.57-0,93) | 1 | 1 | 1 |
INTER-LOW | 0,73 (0,47-0,87) | 0,74 (0.56-0,86) | 0,77(0,55-0,89) | 0,65 (0,50-0,76) |
INTER-HIGH | 0,57 (0.34-0,75) | 0,54 (0,37-0,69) | 0,51 (0,27-0,71) | |
HIGH | 0,40 (0,22-0,58) | 0,47(0,33-0,61) | 0,42 (0,20-0,63) | 0,18 (0,01-0,53) |
Long-Rank; p | 0,002 | 0,002 | 0,002 | <0,001 |
R, Cox: HR and p value | 4,3 (1,8-10,5) 0,001 | 7,64 (1,0-57,8) 0,049 | 10,9 (1,4-86,6) 0,024 | 22,9 (4,3-121,3) <0,001 |
Conclusion
- The application of the prognostic indices to our serie of patients, shows the reproducibility of prognostic indices in real life patients.
- The GELTAMO IPI is the best index to differenciate high-risk patients group, despite the small number of cases.
Keyword(s):
Abstract: EP563
Type: E-Poster Presentation
Session title: Aggressive Non-Hodgkin lymphoma - Clinical
Background
In recent years, different prognostic indices have been developed for diffuse large cell B-cell lymphoma (DLBCL) like the IPI, the R-IPI, the NCCN-IPI and, in our environment, the GELTAMO-IPI which is the only that includes the beta-2 microglobulin. Since the introduction of rituximab, an improvement in response rates and survival has been observed. Nevertheless, patients with an adverse clinical course continue to be observed and their identification is essential to assess alternative therapies
Aims
To analyze the reproducibility of prognostic indices for LBDCG in our serie of patients treated outside of clinical trials; and assess the capacity of the prognostic indices to detect in high-risk patients.
Methods
137 patients diagnosed with DLBCL between June 2004 and June 2020 were included. The treatment was R-CHOP or similar (39 with liposomal doxorrubicin and 5 with etoposide associated to treatment). Furthermore, 29 patients received a 2nd-line treatment, 7 of them with auto-HSCT. We analyzed the prognostic characteristics at diagnosis and the overall survival. We applied 4 prognostic indices: IPI, R-IPI, NCCN-IPI and GELTAMO-IPI.
Survival was studied using the Kaplan-Meyer method and the survival curves were compared with the Log-Rank test. The Cox method was used to calculate the Hazard ratio
Results
Table 1 shows the main prognostic characteristics at diagnosis in our group of patients. With a median follow-up of 25 months, the median overall survival was 120 months (95% CI 42-198). Table 2 shows the different prognostic indices depending on the risk group. In the table 3 we observe the 5-year overall survival, with significant differences in the Log-Rank test with all indexes. All prognostic indices have been significant for the correct distribution of patients according to the risk group, being the GELTAMO-IPI index the best to identify high-risk group patients.
TABLE 1: DATA AT DIAGNOSIS
Age: middle | Sex (M/F) | ECOG>2 | High LDH | Stage III/IV | High Beta-2 microglobulin |
66 (16-88) | 58/79 | 34(28%) | 90 (66%) | 88 (64%) | 63(45%) |
TABLE 2: PROGNOSTIC INDICES DISTRIBUTION BY RISK GROUP PATIENTS
IPI | R-IPI | NCCN-IPI | GELTAMO-IPI | |
LOW | 39 (28%) | 8 (6%) | 10 (7%) | 15 (11%) |
INTER-LOW | 31 (23%) | 62 (45%) | 48 (35%) | 81 (59%) |
INTER-HIGH | 29 (21%) | 52 (38%) | 32 (23%) | |
HIGH | 38 (28%) | 67 (49%) | 27 (20%) | 9 (7%) |
TABLE 3: 5-YEARS OVERALL SURVIVAL BY RISK GROUPS.
IPI | R-IPI | NCCN-IPI | GELTAMO-IPI | |
LOW | 0,82 (0.57-0,93) | 1 | 1 | 1 |
INTER-LOW | 0,73 (0,47-0,87) | 0,74 (0.56-0,86) | 0,77(0,55-0,89) | 0,65 (0,50-0,76) |
INTER-HIGH | 0,57 (0.34-0,75) | 0,54 (0,37-0,69) | 0,51 (0,27-0,71) | |
HIGH | 0,40 (0,22-0,58) | 0,47(0,33-0,61) | 0,42 (0,20-0,63) | 0,18 (0,01-0,53) |
Long-Rank; p | 0,002 | 0,002 | 0,002 | <0,001 |
R, Cox: HR and p value | 4,3 (1,8-10,5) 0,001 | 7,64 (1,0-57,8) 0,049 | 10,9 (1,4-86,6) 0,024 | 22,9 (4,3-121,3) <0,001 |
Conclusion
- The application of the prognostic indices to our serie of patients, shows the reproducibility of prognostic indices in real life patients.
- The GELTAMO IPI is the best index to differenciate high-risk patients group, despite the small number of cases.
Keyword(s):