Standard International Prognostic Index Remains a Valid Predictor of Outcome for Patients With Aggressive CD20<sup>+</sup>B-Cell Lymphoma in the Rituximab Era

Ziepert, Marita; Hasenclever, Dirk; Kuhnt, Evelyn; Glaß, Bertram; Schmitz, Norbert; Pfreundschuh, Michael; Loeffler, Markus

doi:10.1200/jco.2009.26.2493

Cited by 519 publications

(399 citation statements)

References 33 publications

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“…1975-2012: NHL patients registered, with peak incidence between 40-60 years of age whereas HL with peak incidence between 15-39 years as shown in (Ziepert et al, 2010) analyses from 1,062 patients treated with R-CHOP in three prospective clinical trials (MInT, 380 patients; DOI:http://dx.doi.org/10.7314/APJCP.2015.16.5…”

Section: Age Distributionmentioning

confidence: 99%

“…Muhammad Shahzad Rauf*, Saad Akhtar, Irfan Maghfoor relative comparison against, Saudi cancer registry data (SCR 2009;2010), which is a population-based registry established in 1992, gulf countries data and IARC data. We also did brief retrospective analysis outcome of NHL presented to KFSH&RC and its comparison against international trials.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Changing Trends of Adult Lymphoma in the Kingdom of Saudi Arabia - Comparison of Data Sources

Rauf¹,

Akhtar²,

Maghfoor³

2015

Asian Pacific Journal of Cancer Prevention

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Section: Age Distributionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changing Trends of Adult Lymphoma in the Kingdom of Saudi Arabia - Comparison of Data Sources

Rauf¹,

Akhtar²,

Maghfoor³

2015

Asian Pacific Journal of Cancer Prevention

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“…However, with improved outcomes attributed to the addition of rituximab, the identification of a high-risk subset of patients with an anticipated 5-year survival of less than 50% remains a challenge with use of the IPI alone. 1,2 Gene-expression profiling, [3][4][5][6][7] immunohistochemistry-based detection of prognostic biomarkers [8][9][10][11][12][13][14][15][16] and early interim analysis with positron emission tomography 17,18 following the initiation of immunochemotherapy have all been explored as predictors that may identify high-risk patients. Although promising, many of these methods are costly, difficult to obtain, not easily interpreted and require further validation.…”

Section: Introductionmentioning

confidence: 99%

The absolute monocyte and lymphocyte prognostic score predicts survival and identifies high-risk patients in diffuse large-B-cell lymphoma

et al. 2011

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Despite the use of modern immunochemotherapy regimens, almost 50% of patients with diffuse large-B-cell lymphoma will relapse. Current prognostic models, including the International Prognostic Index, incorporate patient and tumor characteristics. In contrast, recent observations show that variables related to host adaptive immunity and the tumor microenvironment are significant prognostic variables in non-Hodgkin lymphoma. Therefore, we retrospectively examined the absolute monocyte and lymphocyte counts as prognostic variables in a cohort of 366 diffuse large-B-cell lymphoma patients who were treated between 1993 and 2007 and followed at a single institution. The absolute monocyte and lymphocyte counts in univariate analysis predicted progression-free and overall survival when analyzed as continuous and dichotomized variables. On multivariate analysis performed with factors included in the IPI, the absolute monocyte and lymphocyte counts remained independent predictors of progression-free and overall survival. Therefore, the absolute monocyte and lymphocyte counts were combined to generate a prognostic score that identified patients with an especially poor overall survival. This prognostic score was independent of the IPI and added to its ability to identify high-risk patients.

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“…Interestingly, IPI was the strongest prognostic factor for patients who received second-line treatment, providing additional evidence for its validity as a predictor in the rituximab era 28 and outweighing the distinction between early and late relapse. The risk-adapted treatment of this study may have contributed to the equalization in OS of patients with early and late relapse, although the data and the skope of the study do not allow to prove this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Risk-adapted, treosulfan-based therapy with auto- and allo-SCT for relapsed/refractory aggressive NHL: a prospective phase-II trial

Koenigsmann

Casper

Kahl

et al. 2013

Bone Marrow Transplant

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Since the outcome of relapsed/refractory aggressive non-Hodgkin's lymphoma (NHL) is highly variable, a risk-adapted treatment approach was evaluated. After two cycles of DHAP, patients received high-dose treosulfan/etoposide/carboplatinum (TEC) and autologous stem cell rescue. After TEC, low-risk patients with late relapse (41 year after first CR who achieved CR after DHAP received no further treatment. Patients with late relapse who achieved CR or PR only after TEC underwent a second cycle of TEC. High-risk patients with early relapse/refractory disease received treosulfan/fludarabine followed by allogeneic transplantation. Rituximab was added in patients with B-cell lymphoma (86%). At entry, 36% of all 57 patients had refractory disease, 32% early and 32% late relapse. During DHAP treatment, progression occurred in 32% of patients. Of 33 patients who received TEC, 5 received second TEC and 15 allogeneic transplantation. Main toxicity after TEC was oral mucositis (CTC grades 3 and 4 in 50% and 13%, respectively). In total, 42% patients achieved CR. Median OS was 21.4 months for all patients and 32.6 for those who underwent allogeneic transplantation. International prognostic index (IPI) at study entry was highly discriminative at predicting OS (Po0.0001). Risk-adapted, treosulfan-based therapy with auto-and allo-SCT is feasible. Long-term survival is possible with allogeneic transplantation. Keywords: relapsed non-Hogkin's lymphoma; treosulfan; autologous transplantation; allogeneic transplantation; risk-adapted therapy INTRODUCTION High-dose chemotherapy with auto-SCT has been the standard approach for relapsed aggressive non-Hodgkin's lymphoma (NHL) since the PARMA trial, 1 which reported a higher 5-year OS rate (53%) compared with that of conventional chemotherapy only (32%). Disease-free survival after a high-dose therapy is higher in cases of chemosensitive relapse than in cases of chemoresistant relapse, 2 and cytoreductive salvage therapy is more efficient after late relapse than after early relapse. 3 The application of allogeneic transplantation for these patients has evolved at a slower pace, 4-8 and a treatment-related mortality greater than 40% has led to the questioning of its role. 9 Treosulfan is an alkylating agent with a steep dose-response curve. High-dose treosulfan and fludarabine before allogeneic transplantation has shown efficacy with little toxicity in AML and myelodysplastic syndromes. 10,11 Treosulfan has also been investigated as a high-dose therapy before auto-SCT in ovarian cancer and other solid tumors. 12,13 A previous study demonstrated its activity in a high-dose combination regimen for relapsed Bone Marrow Transplantation

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Standard International Prognostic Index Remains a Valid Predictor of Outcome for Patients With Aggressive CD20⁺B-Cell Lymphoma in the Rituximab Era

Abstract: The effects of rituximab were superimposed on the effects of CHOP with no interactions between chemotherapy and antibody therapy. These results demonstrate that the IPI is still valid in the R-CHOP era.

Cited by 519 publications

References 33 publications

Changing Trends of Adult Lymphoma in the Kingdom of Saudi Arabia - Comparison of Data Sources

Changing Trends of Adult Lymphoma in the Kingdom of Saudi Arabia - Comparison of Data Sources

The absolute monocyte and lymphocyte prognostic score predicts survival and identifies high-risk patients in diffuse large-B-cell lymphoma

Risk-adapted, treosulfan-based therapy with auto- and allo-SCT for relapsed/refractory aggressive NHL: a prospective phase-II trial

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Standard International Prognostic Index Remains a Valid Predictor of Outcome for Patients With Aggressive CD20+B-Cell Lymphoma in the Rituximab Era

Abstract: The effects of rituximab were superimposed on the effects of CHOP with no interactions between chemotherapy and antibody therapy. These results demonstrate that the IPI is still valid in the R-CHOP era.

Cited by 519 publications

References 33 publications

Changing Trends of Adult Lymphoma in the Kingdom of Saudi Arabia - Comparison of Data Sources

Changing Trends of Adult Lymphoma in the Kingdom of Saudi Arabia - Comparison of Data Sources

The absolute monocyte and lymphocyte prognostic score predicts survival and identifies high-risk patients in diffuse large-B-cell lymphoma

Risk-adapted, treosulfan-based therapy with auto- and allo-SCT for relapsed/refractory aggressive NHL: a prospective phase-II trial

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Standard International Prognostic Index Remains a Valid Predictor of Outcome for Patients With Aggressive CD20⁺B-Cell Lymphoma in the Rituximab Era