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Prognostic factors in patients with diffuse large B cell lymphoma : before and after the introduction of rituximab
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Ngo, L., Hee, Siew Wan, Lim, L. C., Tao, M., Quek, R., Yap, S. P., Loong, E. L., Sng, I., Hwan-Cheong, T. L., Ang, M. K., Ngeow, J., Tham, C. K., Tan, M. H. and Lim, S. T. (2008) Prognostic factors in patients with diffuse large B cell lymphoma : before and after the introduction of rituximab. Leukemia and Lymphoma, 49 (3). pp. 462-469. doi:10.1080/10428190701809156 ISSN 1042-8194 .
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Official URL: http://dx.doi.org/10.1080/10428190701809156
Abstract
This study attempted to evaluate the usefulness of the International Prognostic Index (IPI) as a prognostic model in patients treated with R-CHOP (rituximab, cyclophosphamide, vincristine, adriamycin and prednisolone) chemotherapy. We compared 279 patients with DLBCL. Among them, 183 received CHOP while 96 received R-CHOP. Results showed that there were no statistically significant differences between the two groups of patients in terms of both the patient and the lymphoma characteristics. The estimated 2-year survival was significantly higher among patients treated with R-CHOP compared to CHOP alone (85.6% vs. 64.7%, P = 0.004). Both the IPI and age-adjusted IPI were less useful as prognostic models in patients receiving R-CHOP compared to CHOP. In the multivariate analysis, age ≥ 60, elevated serum LDH, low serum albumin and advanced stages of disease were each independently associated with decreased survival in patients treated with CHOP. In contrast, among those treated with R-CHOP, only male sex and advanced stage of disease were each independently associated with decreased survival. Using these two factors, patients treated with R-CHOP could be separated into three prognostic groups with 5-year estimated survival ranging from 47% to 100% (P < 0.0001). In summary, we can conclude that with the significant improvement in survival following the use of rituximab, the relevance of previously recognized prognostic factors has to be reassessed and re-evaluated.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Leukemia and Lymphoma | ||||
Publisher: | Taylor & Francis | ||||
ISSN: | 1042-8194 | ||||
Official Date: | 2008 | ||||
Dates: |
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Volume: | 49 | ||||
Number: | 3 | ||||
Page Range: | pp. 462-469 | ||||
DOI: | 10.1080/10428190701809156 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Reuse Statement (publisher, data, author rights): | Cited By :22 Export Date: 5 March 2015 | ||||
Access rights to Published version: | Restricted or Subscription Access | ||||
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