Berglund et al evaluated prognostic factors for patients with diffuse large B-cell malignant lymphomas. These can help identify patients who may benefit from more aggressive management. The authors are from Uppsala, Umea, and Lund Universities in Sweden.
Parameters:
(1) International Prognostic Index (IPI) score (see 28.07.04, above)
(2) bcl-6 staining
(3) CD10 staining
(4) IRF-4 staining
(5) bcl-2 expression
A lymphoma was considered to have a germinal center (GC) phenotype if one of the following was present:
(1) CD10 positive (>= 30% staining)
(2) bcl-6 positive (>= 30% staining) AND IRF-4 negative (< 30% staining)
|
Parameter |
Finding |
Points |
|
IPI score |
0 - 2 |
0 |
|
|
3 to 5 |
1 |
|
phenotype |
germinal center |
0 |
|
|
non-germinal center |
1 |
|
bcl-2 expression |
negative |
0 |
|
|
positive (>= 50% staining) |
1 |
number of adverse risk factors =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The more risk factors present the worse the prognosis.
|
IPI Score |
Phenotype |
5 Year Overall Survival |
10 Year Overall Survival |
|
0 to 2 |
germinal center |
80% |
43% |
|
0 to 2 |
non-GC |
35% |
12% |
|
3 to 5 |
germinal center |
24% |
24% |
|
3 to 5 |
non-GC |
20% |
0% |
Specialty: Hematology Oncology
ICD-10: ,
