RT Journal Article
T1 Validation of the NCCN-IPI for diffuse large B-cell lymphoma (DLBCL): the addition of β2 -microglobulin yields a more accurate GELTAMO-IPI.
A1 Montalbán, Carlos
A1 Díaz-López, Antonio
A1 Dlouhy, Ivan
A1 Rovira, Jordina
A1 Lopez-Guillermo, Armando
A1 Alonso, Sara
A1 Martín, Alejandro
A1 Sancho, Juan M
A1 García, Olga
A1 Sánchez, Jose M
A1 Rodríguez, Mario
A1 Novelli, Silvana
A1 Salar, Antonio
A1 Gutiérrez, Antonio
A1 Rodríguez-Salazar, Maria J
A1 Bastos, Mariana
A1 Domínguez, Juan F
A1 Fernández, Rubén
A1 Gonzalez de Villambrosia, Sonia
A1 Queizan, José A
A1 Córdoba, Raul
A1 de Oña, Raquel
A1 López-Hernandez, Andrés
A1 Freue, Julian M
A1 Garrote, Heidys
A1 López, Lourdes
A1 Martin-Moreno, Ana M
A1 Rodriguez, Jose
A1 Abraira, Víctor
A1 García, Juan F
A1 GELTAMO-IPI Project Investigators, 
K1 DLBCL
K1 prognostic scores
K1 risk assessment
AB 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.
YR 2017
FD 2017-01-20
LK http://hdl.handle.net/10668/10794
UL http://hdl.handle.net/10668/10794
LA en
DS RISalud
RD Apr 7, 2025