Diffuse large B-cell lymphoma: sites of extranodal involvement are a stronger prognostic indicator than number of extranodal sites in the rituximab era

作者：Lu Chieh Sheng; Chen Jia Hong; Huang Tzu Chuan; Wu Yi Ying; Chang Ping Ying; Dai Ming Shen; Chen Yeu Chin; Ho Ching Liang^*

来源：Leukemia and Lymphoma, 2015, 56(7): 2047-2055.

DOI：10.3109/10428194.2014.982636

• Diffuse large B-cell lymphoma (DLBCL)
• National Comprehensive Cancer Network (NCCN)
• International Prognostic Index (IPI)
• extranodal involvement

The National Comprehensive Cancer Network (NCCN) International Prognostic Index (IPI) is an enhanced prognostic tool that has identified some specific extranodal sites as a poor prognostic factor. We retrospectively analyzed 148 Taiwanese patients with newly diagnosed diffuse large B-cell lymphoma receiving rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP)-like regimens from January 2001 to December 2010 at the Tri-Service General Hospital. In univarate analysis, >= 2 extranodal involved sites had no significant prognostic relevance (p = 0.108), although extranodal involvement of the lung/pleura, liver, lower urinary tract or bone marrow was a statistically significant poor prognostic factor (p<0.001). In multivariate analysis, specific extranodal sites had a stronger predictive value for poor prognosis (relative risk 3.654, 95% confidence interval 1.514-8.815, p = 0.004) compared with the number of extranodal sites involved. This finding suggests that specific extranodal involved sites have prognostic value in the R era.

• 出版日期2015-7