scholarly journals International Prognostic Index Score

2020 ◽  
Author(s):  
Keyword(s):  
International Prognostic Index ◽  
Prognostic Index ◽  
Index Score ◽  
International Prognostic Index Score

The architectural pattern of FOXP3-positive T cells in follicular lymphoma is an independent predictor of survival and histologic transformation

Blood ◽  
2010 ◽  
Vol 115 (2) ◽  
pp. 289-295 ◽  
Author(s):  
Pedro Farinha ◽  
Abdulwahab Al-Tourah ◽  
Karamjit Gill ◽  
Richard Klasa ◽  
Joseph M. Connors ◽  
...  
Keyword(s):  
T Cells ◽  
Follicular Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Progression Free Survival ◽  
Tissue Microarrays ◽  
Index Score ◽  
Cell Distribution ◽  
Cell Content ◽  
International Prognostic Index Score

Abstract Previous studies of follicular lymphoma (FL) patients treated heterogeneously have suggested that decreased numbers of regulatory T cells correlates with improved survival. We studied advanced-stage FL patients from a single institution phase 2 trial. All patients were treated uniformly with multiagent chemotherapy and radiation. Tissue microarrays were constructed using diagnostic biopsies available in 105 patients and stained with CD4, CD8, CD25, and forkhead/winged helix transcription factor 3 (FOXP3) antibodies. Both cell content and cell distribution were evaluated. For all antibodies, there were cases with a predominant intrafollicular or perifollicular localization of cells (follicular pattern) while others displayed a diffuse pattern. The median follow-up of living patients was 17.1 years. The International Prognostic Index score predicted overall survival (OS; P = .004) but not risk of transformation (RT). Cell content did not impact survival, while immunoarchitectural patterns of CD4/CD8 were significant for progression-free survival (PFS; P = .056), CD25 for both PFS and OS (P = .002 and P = .024, respectively), and FOXP3+ predicted PFS, OS, and RT (P = .001, P < .001 and p = .002, respectively). A Cox multivariate model showed both International Prognostic Index score and FOXP3+ pattern were independent predictors of OS (P = .008 and P < .001, respectively), while only FOXP3+ pattern predicted RT (P = .004). We conclude that FOXP3+ cell distribution significantly predicts survival and RT in FL.

scholarly journals Results of immuno-chemotherapeutic treatment of patients with diffuse large B-cell lymphoma

2009 ◽  
Vol 150 (44) ◽  
pp. 2019-2026
Author(s):  
Tamás Schneider ◽  
Zsuzsanna Molnár ◽  
Beáta Deák ◽  
Erika Várady ◽  
Erika Tóth ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Index Score ◽  
International Prognostic Index Score ◽  
Large B Cell Lymphoma ◽  
Chemotherapeutic Treatment ◽  
Large B Cell

A cyclophosphamid-doxorubicin-vincristin-prednisolon (CHOP-) kezelés több mint 20 éven át standard kezelésnek számított a diffúz nagy B-sejtes lymphomák (DLBCL) elsődleges kezelésében. A CHOP-kezelést célzott immunterápiával, rituximabbal kiegészítve (R-CHOP) jelentős javulás volt elérhető e betegcsoport kezelésében. Magyar betegcsoporton még nem ismert olyan adat, amely a kezelés túlélésre kifejtett hatását vizsgálná. A szerzők célja az R-CHOP és az R-CHOP-like kezelés hatékonyságának elemzése volt. 2002. szeptember és 2005. április között 140 újonnan diagnosztizált, kezeletlen DLBCL-es beteg R-CHOP-kezelését kezdték. A vizsgálatba beválasztás előfeltétele az előrehaladott III–IV. klinikai stádium, vagy I–II. klinikai stádium esetén nagy tumor (>7 cm), és/vagy „B” tünet, illetve extranodalis manifesztáció voltak. Az eredményeket a korábbi években CHOP- és CHOP-like kezelésben részesült 130 beteg adataival vetették össze. A terápiás eredmények minden paramétert tekintve kedvezőbbnek bizonyultak az R-CHOP-kezeltek körében. Az átlagos 44, illetve 52 hónapos követési idő során a teljes remissziós arány 73,6% volt szemben a CHOP-csoportban észlelt 47,7%-kal. Az ötéves teljes túlélés 68,6% vs. 41,0% (RR: 0,4293, CI: 0,2963–0,6221; p < 0,0001), az eseménymentes túlélés 59,8% vs. 33,5% (RR: 0,5038, CI: 0,36,6–0,7038; p < 0,0001), míg a progressziómentes túlélés 64,4% vs. 37,6% (RR: 0,4915, CI: 0,3442–0,7019; p < 0,0001) volt. Mivel a prognosztikus paraméterek az R-CHOP-csoportban valamelyest kedvezőbbek voltak, ezért a Sehn által ajánlott módosított international prognostic index score beosztása alapján képzett betegcsoportok eredményeit is összevetették. Az alcsoportelemzés itt is szignifikáns különbségeket adott. Az ötéves teljes túlélés a jó prognózisú csoportban 74,4% vs. 47,9% (RR: 0,4475, CI: 0,2418–0,8285; p = 0,0084), a rossz prognózisú csoportban 52,0% vs. 28,8% (RR: 0,4989, CI: 0,3098–0,8035; p = 0,003) volt. A nagyon jó prognózisú csoportban a két csoport között statisztikai különbség az ötéves túlélési paraméterekben a már eleve igen nagy terápiás hatás és a kicsi esetszám miatt nem észlelhető (OS és EFS: CHOP: 100% és 62,5% vs. R-CHOP: 90,9% és 87,0%; p = 0,3873 és p = 0,1702). Rituximab hozzáadása a standard CHOP-kezeléshez a terápiás eredmények jelentős javulását eredményezte prognosztikus csoportoktól függetlenül. Az eredmények a nemzetközi irodalmi adatokkal összevethetők.

scholarly journals Short regimen of rituximab plus lenalidomide in follicular lymphoma patients in need of first-line therapy

Blood ◽  
2019 ◽  
Vol 134 (4) ◽  
pp. 353-362 ◽  
Author(s):  
Emanuele Zucca ◽  
Stephanie Rondeau ◽  
Anna Vanazzi ◽  
Bjørn Østenstad ◽  
Ulrich J. M. Mey ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Progression Free Survival ◽  
Complete Response ◽  
Clinical Cancer Research ◽  
International Prognostic Index Score ◽  
First Line Therapy ◽  
Phase 2 Trial ◽  
Grade 3

Abstract The SAKK 35/10 phase 2 trial, developed by the Swiss Group for Clinical Cancer Research and the Nordic Lymphoma Group, compared the activity of rituximab vs rituximab plus lenalidomide in untreated follicular lymphoma patients in need of systemic therapy. Patients were randomized to rituximab (375 mg/m2 IV on day 1 of weeks 1-4 and repeated during weeks 12-15 in responding patients) or rituximab (same schedule) in combination with lenalidomide (15 mg orally daily for 18 weeks). Primary end point was complete response (CR)/unconfirmed CR (CRu) rate at 6 months. In total, 77 patients were allocated to rituximab monotherapy and 77 to the combination (47% poor-risk Follicular Lymphoma International Prognostic Index score in each arm). A significantly higher CR/CRu rate at 6 months was documented in the combination arm by the investigators (36%; 95% confidence interval [CI], 26%-48% vs 25%; 95% CI, 16%-36%) and confirmed by an independent response review of computed tomography scans only (61%; 95% CI, 49%-72% vs 36%; 95% CI, 26%-48%). After a median follow-up of 4 years, significantly higher 30-month CR/CRu rates and longer progression-free survival (PFS) and time to next treatment (TTNT) were observed for the combination. Overall survival (OS) rates were similar in both arms (≥90%). Toxicity grade ≥3 was more common in the combination arm (56% vs 22% of patients), mainly represented by neutropenia (23% vs 7%). Addition of lenalidomide to rituximab significantly improved CR/CRu rates, PFS, and TTNT, with expected higher, but manageable toxicity. The excellent OS in both arms suggests that chemotherapy-free strategies should be further explored. This trial was registered at www.clinicaltrials.gov as #NCT01307605.

Fludarabine, Mitoxantrone and Dexametasone in the Treatment of Relapsed and Refractory Low-Grade Non-Hodgkin Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4738-4738
Author(s):  
Joanna Sawczuk-Chabin ◽  
Ewa Kalinka ◽  
Piotr Centkowski ◽  
Katarzyna Budziszewska ◽  
Bernadeta Ceglarek ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Performance Status ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Response Duration ◽  
Low Grade ◽  
International Prognostic Index Score ◽  
Non Hodgkin Lymphoma ◽  
D 20 ◽  
Grade Iii

Abstract The purpose of the study was to evaluate response, duration of response, and toxicity of fludarabine (F), mitoxantrone (M), and dexamethason (D) (FMD) in patients (pts) with relapsed or refractory low-grade non-Hodgkin lymphoma (LGNHL). 26 pts with advanced relapsed/refractory LGNHL exposed to previous chemotherapy (CHT) received 3–6 monthly cycles of FMD. The median age was 60 years (range 34–73), included 13 male (50%) and 13 female (50 %). The regimen consisted of F (25 mg/m2 i.v., day 1–3), M (10 mg/m2 i.v., day 1) and D (20 mg p.o., day 1–5). Parameters analyzed included response, toxicity and infection rates, number of previous CHT lines, performance status (ECOG), Ann Arbor scale, LDH, International Prognostic Index score, freedom from progression (FFP) and overall survival (OS). In total 78 cycles of FMD was administered. This induced 25% complete and 37,5% partial response, with a total response rate of 62,5%. After 14 months of the median follow-up of the pts remaining alive, median FFP was 11 months and median OS has not been achieved yet. Out of 78 administered cycles 16 (20%) were associated with toxicity, including 8 (10%) severe infections despite prophylaxis and 6 (8%) grade III/IV neutropenias. In addition, one case of grade III/IV thrombocytopenia and acute noninflammatory renal dysfunction were observed. Toxicity rate was not correlated with the number of previous CHT lines or ECOG, but IPI >2 was significant factor predictive for FMD-related toxicity (p=.037). Shorter OS was observed for the pts with ECOG>1 (p=.049), IPI>2 (p=.005) and FMD-related toxicity (p=.036). FMD is an active regimen for relapsed and refractory LGNHL. Toxicity rate is substantial and seems to predict survival.

scholarly journals Lymphomas with concurrent BCL2 and MYC translocations: the critical factors associated with survival

Blood ◽  
2009 ◽  
Vol 114 (11) ◽  
pp. 2273-2279 ◽  
Author(s):  
Nathalie A. Johnson ◽  
Kerry J. Savage ◽  
Olga Ludkovski ◽  
Susana Ben-Neriah ◽  
Ryan Woods ◽  
...  
Keyword(s):  
Overall Survival ◽  
B Cell ◽  
Cell Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
International Prognostic Index Score ◽  
Risk Patients ◽  
Bcl2 Protein

Abstract BCL2 and MYC are oncogenes commonly deregulated in lymphomas. Concurrent BCL2 and MYC translocations (BCL2+/MYC+) were identified in 54 samples by karyotype and/or fluorescence in situ hybridization with the aim of correlating clinical and cytogenetic characteristics to overall survival. BCL2+/MYC+ lymphomas were diagnosed as B-cell lymphoma unclassifiable (BCLU; n = 36) with features intermediate between Burkitt lymphoma and diffuse large B-cell lymphoma (DLBCL); DLBCL (n = 17), or follicular lymphoma (n = 1). Despite the presence of a t(14;18), 5 cases were BCL2 protein–negative. Nonimmunoglobulin gene/MYC (non-IG/MYC) translocations occurred in 24 of 54 cases (44%) and were highly associated with DLBCL morphology (P < .001). Over a median follow-up of 5.3 years, 6 patients remained in remission and 32 died within 6 months of the MYC+ rearrangement, irrespective of whether MYC+ occurred at diagnosis (31 of 54) or transformation (23 of 54; P = .53). A non-IG/MYC translocation partner, absent BCL2 protein expression and treatment with rituximab-based chemotherapy, were associated with a more favorable outcome, but a low International Prognostic Index score and DLBCL morphology were independent predictors of overall survival. A comprehensive cytogenetic analysis of BCL2 and MYC status on all aggressive lymphomas may identify a group of high-risk patients who may benefit from chemotherapeutic regimens that include rituximab and/or BCL2-targeted therapy.

scholarly journals PRIMARY BONE LYMPHOMAS: RETROSPECTIVE ANALYSIS OF 42 CONSECUTIVE CASES

2018 ◽  
Vol 26 (2) ◽  
pp. 103-107
Author(s):  
TELMA MURIAS DOS SANTOS ◽  
JUAN PABLO ZUMÁRRAGA ◽  
FÁBIO MAZETTI REAES ◽  
CARLOS HENRIQUE MAÇANEIRO JUNIOR ◽  
ANDRÉ MATHIAS BAPTISTA ◽  
...  
Keyword(s):  
Chemotherapy Regimen ◽  
International Prognostic Index ◽  
Case Series ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Low Grade ◽  
Level Of Evidence ◽  
International Prognostic Index Score ◽  
Primary Bone

ABSTRACT Objective: It is difficult to define parameters for management and factors associated with primary bone lymphoma (PBL). This article presents the experience in a single institution with 42 patients with PBL over a 16-year period (2000-2016). Methods: Fifty-five patients were retrospectively evaluated, and forty-two were included (76.3%). Results: Median age at diagnosis was 51.5 years, and median follow-up was 102.7 months. One patient had HIV. Pain in the affected site was the most prevalent symptom. The average time between symptom onset and diagnosis was 5.4 months. The vertebrae were most affected (n=16, 33.3%). According to the International Prognostic Index Score (IPI), 64.3% of the patients were classified as having low-grade lymphoma and 25.7% as low-intermediate. The most common histology was diffuse large B cell lymphoma (DLBCL) (85.7%). Immunophenotyping was CD20 positive in 93.5% of patients, and 11 patients had pathological fracture. All patients received chemotherapy and 30% of the regimens included rituximab. Thirty-eight percent of patients received radiation therapy. Overall survival was 50%, and survival median time was 80 months. Age and chemotherapy regimen influenced patient survival. Younger patients and patients who received RCHOP had better prognoses. Conclusions: The choice of chemotherapy regimen associated with age influenced survival for patients with PBL. Level of Evidence IV; Case series.

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