Gutierrez, AntonioBento, LeyreDiaz-Lopez, AntonioBarranco, GilbertoGarcia-Recio, MartaLopez-Guillermo, ArmandoDlouhy, IvanRovira, JordinaRodriguez, MarioSanchez Pina, Jose MaríaBaile, MonicaMartín, AlejandroNovelli, SilvanaSancho, Juan-ManuelGarcía, OlgaSalar, AntonioBastos-Oreiro, MarianaRodriguez-Salazar, Mª JoséFernandez, Rubende la Cruz, FatimaQueizan, Jose AntonioGonzález de Villambrosia, SoniaCordoba, RaulLópez, AndresLuzardo, HugoGarcía, DanielSastre-Serra, JordiGarcia, Juan FernandoMontalban, CarlosCabanillas, FernandoRodríguez, Jose2023-02-082023-02-082020-02-18http://hdl.handle.net/10668/14791Diffuse large B-cell lymphoma (DLBCL) is an aggressive heterogeneous lymphoma with standard treatment. However, 30%-40% of patients still fail, so we should know which patients are candidates for alternative therapies. IPI is the main prognostic score but, in the rituximab era, it cannot identify a very high-risk (HR) subset. The MD Anderson Cancer Center reported a score in the prerituximab era exclusively considering tumor-related variables: Tumor Score (TS). We aim to validate TS in the rituximab era and to analyze its current potential role. From GELTAMO DLBCL registry, we selected those patients homogeneously treated with R-CHOP (n = 1327). Five-years PFS and OS were 62% and 74%. All variables retained an independent prognostic role in the revised TS (R-TS), identifying four different risk groups, with 5-years PFS of 86%, 71%, 50%, and very HR (28%). With a further categorization of three variables of the original TS (Ann Arbor Stage, LDH and B2M), we generated a new index that allowed an improvement in HR assessment. (a) All variables of the original TS retain an independent prognostic role, and R-TS remains predictive in the rituximab era; (b) R-TS and additional categorization of LDH, B2M, and AA stage (enhanced TS) increased the ability to identify HR subsets.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/diffuse large B-cell lymphomainternational prognostic indexprognosisscoretumor scoreAdolescentAdultAgedAntineoplastic Agents, ImmunologicalAntineoplastic Combined Chemotherapy ProtocolsCyclophosphamideDoxorubicinFemaleHumansLymphoma, Large B-Cell, DiffuseMaleMiddle AgedNeoplasm GradingNeoplasm StagingPrednisonePrognosisRegistriesRituximabSurvival AnalysisTreatment OutcomeVincristineYoung Adultresearch article31804029open access10.1111/ejh.133641600-0609PMC7217048https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ejh.13364https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217048/pdf