Patient selection: diffuse large cell lymphoma
MACOP-8 (8 drugs: doxorubicin, cyclophosphamide, vincristine, bleomycin, methotrexate, cotrimoxazole, ketoconazole)
Parameters (present at diagnosis):
(1) B symptoms (night sweats, fever, unexplained weight loss)
(2) number of lymph node sites/groups involved
(3) number of extranodal sites involved
(4) age of the patient in years
|
Parameter
|
Finding
|
Points
|
|
B symptoms
|
absent
|
0
|
|
|
present
|
1
|
|
number of lymph node groups involved
|
<= 2
|
0
|
|
|
>= 3
|
1
|
|
number of extranodal sites involved
|
<= 1
|
0
|
|
|
>= 2
|
1
|
|
age of the patient
|
<= 60 years of age
|
0
|
|
|
> 60 years of age
|
1
|
where:
• The first 3 items relate to tumor burden.
• Age relates to the patient's ability to tolerate chemotherapy.
total number of risk factors present =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The higher the score the greater the 5 year mortality rate.
simple predictive model for 5 year survival in percent =
= MIN(100, 30 * (4 - (total number of risk factors)))
