Melchardt et al proposed a modified NCCN-IPI score for older adults with diffuse large B-cell lymphoma (DLBCL). This can help to identify a patient who may benefit from more aggressive management. The authors are from Paracelsus Medical University, University of Graz, Medical University of Innsbruck and University of Texas MD Anderson Cancer Center.
Patient selection: age > 60 years with DLBCL
Parameters:
(1) NCCN-IPI score (range from 0 to 8)
(2) serum albumin in g/L
(3) serum beta2-microglobulin in mg/L
NCCN-IPI Score
Risk Group
2 (for age > 60)
low risk
3-5
intermediate
>= 6
high
Additional factors associated with a worse prognosis:
(1) serum albumin < 35 g/L
(2) serum beta2-microglobulin > 3.0 mg/L
modified NCCN-IPI =
= (original NCCN-IPI) + (2 points if serum albumin < 35 g/L)
Interpretation:
• minimum score: 0 or 2 (for age > 60 in NCCN-IPI)
• maximum score: 10
Score
Risk Group
5-Year Overall Survival
0-2
low
94%
3
intermediate-low
78%
4-7
intermediate-high
56%
8-10
high
37%
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