Prognostic Factors in Diffuse Large Bcell Lymphoma Treated by Riskadopted Therapy

概要

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Objective: The International Prognostic Index (IPI) was reported in 1993 and it is now widely used for predicting the outcome in patients with aggressive nonHodgkins lymphoma. It defines 5 risk factors and 4 distinct risk groups from retrospective data. In this study, we evaluated the outcome of riskadopted therapy for diffuse large Bcell lymphoma (DLBCL), the most common aggressive lymphoma, and assessed the possible prognostic factors. Methods and Patients: We treated 177 consecutive patients newly diagnosed with DLBCL using therapies determined by putative risk factors. Therapies included CHOP followed by involved field irradiation; ACOMPB with the consolidation regimen MLY9; highdose chemotherapy supported by autologous peripheral blood stem cell transplantation; or performance status (PS) oriented CHOP. Statistical analysis was performed to determine the comprehensive risk factors in DLBCL. Results: Overall, the complete response (CR), 3year overall survival (OS), and 3year relapsefree survival (RFS) rates for CR patients were 71%, 69%, and 75%, respectively. Male gender, high LDH, poor PS (≥2), more than one extranodal involvement site, and B symptoms were independent adverse prognostic factors for OS. High LDH and poor PS were independent, adverse prognostic factors for RFS. Conclusion: In the 5 risk factors indicated by IPI, high LDH and poor PS remained for OS and RFS even after riskadopted therapy.