Outcome prediction by extranodal involvement, IPI, and R-IPI in the PET/CT and rituximab era: A Danish-Canadian study of 443 patients with diffuse-large B-cell lymphoma
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Outcome prediction by extranodal involvement, IPI, and R-IPI in the PET/CT and rituximab era : A Danish-Canadian study of 443 patients with diffuse-large B-cell lymphoma. / El-Galaly, Tarec Christoffer; Villa, Diego; Alzahrani, Musa; Hansen, Jakob Werner; Sehn, Laurie H; Wilson, Don; de Nully Brown, Peter; Loft, Annika; Iyer, Victor; Johnsen, Hans Erik; Savage, Kerry J; Connors, Joseph M; Hutchings, Martin.
In: American Journal of Hematology, Vol. 90, No. 11, 11.2015, p. 1041–1046.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Outcome prediction by extranodal involvement, IPI, and R-IPI in the PET/CT and rituximab era
T2 - A Danish-Canadian study of 443 patients with diffuse-large B-cell lymphoma
AU - El-Galaly, Tarec Christoffer
AU - Villa, Diego
AU - Alzahrani, Musa
AU - Hansen, Jakob Werner
AU - Sehn, Laurie H
AU - Wilson, Don
AU - de Nully Brown, Peter
AU - Loft, Annika
AU - Iyer, Victor
AU - Johnsen, Hans Erik
AU - Savage, Kerry J
AU - Connors, Joseph M
AU - Hutchings, Martin
N1 - © 2015 Wiley Periodicals, Inc.
PY - 2015/11
Y1 - 2015/11
N2 - PURPOSE: 18F-fluorodeoxyglucose PET/CT (PET/CT) is the current state-of-the-art in the staging of diffuse large B-cell lymphoma (DLBCL) and has a high sensitivity for extranodal involvement. Therefore, reassessment of extranodal involvement and the current prognostic indices in the PET/CT era is warranted. We screened patients with newly diagnosed DLBCL seen at the academic centers of Aalborg, Copenhagen, and British Columbia for eligibility. Patients that had been staged with PET/CT and treated with R-CHOP(-like) 1(st) line treatment were retrospectively included.FINDINGS: In total 443 patients met the inclusion criteria. With a median follow-up of 2.4 years, the 3-year overall (OS) and progression-free survival (PFS) were 73% and 69%, respectively. The Ann Arbor classification had no prognostic impact in itself with the exception of stage IV disease (HR 2.14 for PFS, P<0.01). Extranodal involvement was associated with a worse outcome in general, and in particular for patients with involvement of >2 extranodal sites, including HR 7.81 for PFS, p<0.001 for >3 sites. Bone/bone marrow involvement was the most commonly involved extranodal site identified by PET/CT (29%) and were associated with an inferior PFS and OS. The IPI, R-IPI, and NCCN-IPI were predictive of PFS and OS, and the two latter could identify a very good prognostic subgroup with 3-year PFS and OS of 100%.CONCLUSIONS: PET/CT-ascertained extranodal involvement in DLBCL is common and involvement of >2 extranodal sites is associated with a dismal outcome. The IPI, R-IPI, and NCCN-IPI predict outcome with high accuracy. This article is protected by copyright. All rights reserved.
AB - PURPOSE: 18F-fluorodeoxyglucose PET/CT (PET/CT) is the current state-of-the-art in the staging of diffuse large B-cell lymphoma (DLBCL) and has a high sensitivity for extranodal involvement. Therefore, reassessment of extranodal involvement and the current prognostic indices in the PET/CT era is warranted. We screened patients with newly diagnosed DLBCL seen at the academic centers of Aalborg, Copenhagen, and British Columbia for eligibility. Patients that had been staged with PET/CT and treated with R-CHOP(-like) 1(st) line treatment were retrospectively included.FINDINGS: In total 443 patients met the inclusion criteria. With a median follow-up of 2.4 years, the 3-year overall (OS) and progression-free survival (PFS) were 73% and 69%, respectively. The Ann Arbor classification had no prognostic impact in itself with the exception of stage IV disease (HR 2.14 for PFS, P<0.01). Extranodal involvement was associated with a worse outcome in general, and in particular for patients with involvement of >2 extranodal sites, including HR 7.81 for PFS, p<0.001 for >3 sites. Bone/bone marrow involvement was the most commonly involved extranodal site identified by PET/CT (29%) and were associated with an inferior PFS and OS. The IPI, R-IPI, and NCCN-IPI were predictive of PFS and OS, and the two latter could identify a very good prognostic subgroup with 3-year PFS and OS of 100%.CONCLUSIONS: PET/CT-ascertained extranodal involvement in DLBCL is common and involvement of >2 extranodal sites is associated with a dismal outcome. The IPI, R-IPI, and NCCN-IPI predict outcome with high accuracy. This article is protected by copyright. All rights reserved.
U2 - 10.1002/ajh.24169
DO - 10.1002/ajh.24169
M3 - Journal article
C2 - 26260224
VL - 90
SP - 1041
EP - 1046
JO - American Journal of Hematology
JF - American Journal of Hematology
SN - 0361-8609
IS - 11
ER -
ID: 144737165