%0 Journal Article
%A Montalbán, Carlos
%A Díaz-López, Antonio
%A Dlouhy, Ivan
%A Rovira, Jordina
%A Lopez-Guillermo, Armando
%A Alonso, Sara
%A Martín, Alejandro
%A Sancho, Juan M
%A García, Olga
%A Sánchez, Jose M
%A Rodríguez, Mario
%A Novelli, Silvana
%A Salar, Antonio
%A Gutiérrez, Antonio
%A Rodríguez-Salazar, Maria J
%A Bastos, Mariana
%A Domínguez, Juan F
%A Fernández, Rubén
%A Gonzalez de Villambrosia, Sonia
%A Queizan, José A
%A Córdoba, Raul
%A de Oña, Raquel
%A López-Hernandez, Andrés
%A Freue, Julian M
%A Garrote, Heidys
%A López, Lourdes
%A Martin-Moreno, Ana M
%A Rodriguez, Jose
%A Abraira, Víctor
%A García, Juan F
%A GELTAMO-IPI Project Investigators
%T Validation of the NCCN-IPI for diffuse large B-cell lymphoma (DLBCL): the addition of β2 -microglobulin yields a more accurate GELTAMO-IPI.
%D 2017
%U http://hdl.handle.net/10668/10794
%X The study included 1848 diffuse large B-cell lymphoma (DLBCL)patients treated with chemotherapy/rituximab. The aims were to validate the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) and explore the effect of adding high Beta-2 microglobulin (β2M), primary extranodal presentation and intense treatment to the NCCN-IPI variables in order to develop an improved index. Comparing survival curves, NCCN-IPI discriminated better than IPI, separating four risk groups with 5-year overall survival rates of 93%, 83%, 67% and 49%, but failing to identify a true high-risk population. For the second aim the series was split into training and validation cohorts: in the former the multivariate model identified age, lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, Stage III-IV, and β2M as independently significant, whereas the NCCN-IPI-selected extranodal sites, primary extranodal presentation and intense treatments were not. These results were confirmed in the validation cohort. The Grupo Español de Linfomas/Trasplante de Médula ósea (GELTAMO)-IPI developed here, with 7 points, significantly separated four risk groups (0, 1-3, 4 or ≥5 points) with 11%, 58%, 17% and 14% of patients, and 5-year overall survival rates of 93%, 79%, 66% and 39%, respectively. In the comparison GELTAMO IPI discriminated better than the NCCN-IPI. In conclusion, GELTAMO-IPI is more accurate than the NCCN-IPI and has statistical and practical advantages in that the better discrimination identifies an authentic high-risk group and is not influenced by primary extranodal presentation or treatments of different intensity.
%K DLBCL
%K prognostic scores
%K risk assessment
%~