A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie, Research Support, N.I.H., Extramural, práce podpořená grantem
Grantová podpora
P30 CA086862
NCI NIH HHS - United States
P50 CA097274
NCI NIH HHS - United States
U01 CA195568
NCI NIH HHS - United States
PubMed
29666118
PubMed Central
PMC6034646
DOI
10.1182/blood-2017-11-816405
PII: S0006-4971(20)32102-9
Knihovny.cz E-zdroje
- MeSH
- beta-2-mikroglobulin metabolismus MeSH
- folikulární lymfom * metabolismus mortalita patologie terapie MeSH
- imunoterapie * MeSH
- kostní dřeň metabolismus patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- nádorové proteiny metabolismus MeSH
- přežití po terapii bez příznaků nemoci MeSH
- protokoly antitumorózní kombinované chemoterapie aplikace a dávkování MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Research Support, N.I.H., Extramural MeSH
- Názvy látek
- beta-2-mikroglobulin MeSH
- nádorové proteiny MeSH
In follicular lymphoma (FL), no prognostic index has been built based solely on a cohort of patients treated with initial immunochemotherapy. There is currently a need to define parsimonious clinical models for trial stratification and to add on biomolecular factors. Here, we confirmed the validity of both the follicular lymphoma international prognostic index (FLIPI) and the FLIPI2 in the large prospective PRIMA trial cohort of 1135 patients treated with initial R-chemotherapy ± R maintenance. Furthermore, we developed a new prognostic tool comprising only 2 simple parameters (bone marrow involvement and β2-microglobulin [β2m]) to predict progression-free survival (PFS). The final simplified score, called the PRIMA-PI (PRIMA-prognostic index), comprised 3 risk categories: high (β2m > 3 mg/L), low (β2m ≤ 3 mg/L without bone marrow involvement), and intermediate (β2m ≤ 3 mg/L with bone marrow involvement). Five-year PFS rates were 69%, 55%, and 37% in the low-, intermediate-, and high-risk groups, respectively (P < .0001). In addition, achieving event-free survival (EFS) or not at 24 months (EFS24) was a strong posttreatment prognostic parameter for subsequent overall survival, and the PRIMA-PI was correlated with EFS24. The results were confirmed in a pooled external validation cohort of 479 patients from the FL2000 LYSA trial and the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource. Five-year EFS in the validation cohort was 77%, 57%, and 44% in the PRIMA-PI low-, intermediate-, and high-risk groups, respectively (P < .0001). The PRIMA-PI is a novel and easy-to-compute prognostic index for patients initially treated with immunochemotherapy. This could serve as a basis for building more sophisticated and integrated biomolecular scores.
4th Department of Internal Medicine Hematology University Hospital Hradec Kralove Czech Republic
Centre Hospitalier de la Roche sur Yon Roche sur Yon France
Centre Hospitalier Pontchaillou Rennes France
CHU de Reims and Université Reims Champagne Ardenne Reims France
Chulalongkorn University Bangkok Thailand
Deparment of Biostatistics Lysarc Lyon France
Department of Haematology Concord Repatriation General Hospital Concord Sydney NSW Australia
Department of Health Sciences Research Mayo Clinic Rochester MN
Department of Hematology Centre Hospitalier Universitaire de Tours Tours France
Department of Internal Medicine University of Iowa College of Medicine Iowa City IA; and
Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN
Division of Hematology Mayo Clinic Rochester MN
Faculty of Medicine Charles University Prague Hradec Kralove Czech Republic
Hematology Department Cliniques Universitaires UCL Saint Luc Brussels Belgium
Hospital Son Llàtzer Palma de Mallorca Spain
Institut Gustave Roussy Villejuif France
Institut Paoli Calmettes Marseille France
Peter MacCallum Cancer Centre and University of Melbourne Melbourne VIC Australia
Polyclinique Bordeaux Nord Aquitaine Bordeaux France
Portuguese Institute of Oncology Lisbon Portugal
Sydney Medical School University of Sydney Sydney NSW Australia
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