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Relapsed/Refractory International Prognostic Index (R/R-IPI): An international prognostic calculator for relapsed/refractory diffuse large B-cell lymphoma
- Source :
- Am J Hematol, Maurer, M J, Jakobsen, L H, Mwangi, R, Schmitz, N, Farooq, U, Flowers, C R, de Nully Brown, P, Thompson, C A, Frederiksen, H, Cunningham, D, Jørgensen, J, Poeschel, V, Nowakowski, G, Seymour, J F, Merli, F, Haioun, C, Ghesquieres, H, Ziepert, M, Tilly, H, Salles, G, Shi, Q, El-Galaly, T C & Habermann, T M 2021, ' Relapsed / Refractory International Prognostic Index (R/R-IPI) : An international prognostic calculator for relapsed/refractory diffuse large B-cell lymphoma ', American Journal of Hematology, vol. 96, no. 5, pp. 599-605 . https://doi.org/10.1002/ajh.26149, Maurer, M J, Jakobsen, L H, Mwangi, R, Schmitz, N, Farooq, U, Flowers, C R, de Nully Brown, P, Thompson, C A, Frederiksen, H, Cunningham, D, Jørgensen, J, Poeschel, V, Nowakowski, G, Seymour, J F, Merli, F, Haioun, C, Ghesquieres, H, Ziepert, M, Tilly, H, Salles, G, Shi, Q, El-Galaly, T C & Habermann, T M 2021, ' Relapsed/Refractory International Prognostic Index (R/R-IPI) : An international prognostic calculator for relapsed/refractory diffuse large B-cell lymphoma ', American Journal of Hematology, vol. 96, no. 5, pp. 599-605 . https://doi.org/10.1002/ajh.26149
- Publication Year :
- 2021
-
Abstract
- Disease progression after frontline therapy for Diffuse large B-cell lymphoma (DLBCL) is a clinically significant event. Patients who experience early progression or have refractory disease have especially poor outcomes. Simple, clinically applicable prognostic tools are needed for selecting patients for consideration for novel therapies and prognostication in the relapsed/refractory (R/R) setting. Model building was performed in patients from the Surrogate endpoints in aggressive lymphoma (SEAL) consortium with disease progression after frontline immunochemotherapy. The primary endpoint was overall survival (OS) measured from date of progression. Validation was performed in the University of Iowa/Mayo Clinic SPORE Molecular Epidemiology Resource (MER) and Danish National Lymphoma Register (LYFO) cohorts. Model performance was assessed using time-dependent concordance indices (c-statistic) and calibration with metrics evaluated at 2 years from progression. Note, 1234 of 5112 patients treated with frontline immunochemotherapy in the SEAL consortium developed progressive disease. Time to progression on immunochemotherapy and age at progression were strongly associated with post-progression OS (both p < 0.001). A prognostic model was developed incorporating spline fit for both variables. The model had good concordance in the discovery (0.67) and validation sets (LYFO c = 0.64, MER c = 0.68) with generally good calibration. Time to progression on frontline therapy is strongly associated with post-progression OS in DLBCL. We developed and validated a simple to apply clinical prognostic tool in the R/R setting. The useful prediction of expected outcomes in R/R DLBCL and can inform treatment decisions such as considerations for CAR-T therapy as well as trial designs. The model is available in smartphone-based point of care applications.
- Subjects :
- Oncology
Male
Risk
medicine.medical_specialty
Concordance
Point-of-Care Systems
Aggressive lymphoma
Kaplan-Meier Estimate
Severity of Illness Index
Article
Cohort Studies
International Prognostic Index
Recurrence
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Clinical endpoint
Medicine
Humans
Aged
Aged, 80 and over
business.industry
Surrogate endpoint
Hematology
Middle Aged
Models, Theoretical
medicine.disease
Prognosis
Combined Modality Therapy
Mobile Applications
Lymphoma
Lymphoma, Large B-Cell, Diffuse/drug therapy
Treatment Outcome
Drug Resistance, Neoplasm
Disease Progression
Female
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Immunotherapy
Lymphoma, Large B-Cell, Diffuse
Smartphone
business
Diffuse large B-cell lymphoma
Progressive disease
Subjects
Details
- ISSN :
- 10968652
- Volume :
- 96
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- American journal of hematology
- Accession number :
- edsair.doi.dedup.....d42d988e420a248fcb90d67e5f3c76af