Barrans et al evaluated prognostic factors for a patient with diffuse large B-cell lymphoma (DLBCL). These can help to identify a patient who may require more aggressive management. The authors are from Leeds General Infirmary, Nottingham City Hospital and Hull Royal Infirmary.
Patient selection: diffuse large B-cell lymphoma (DLBCL)
Parameters:
(1) International Prognostic Index (IPI), from 0 to 5
(2) germinal center (GC) phenotype (positive for CD10 and bcl-6)
(3) bcl-2 (positive if present in > 50% of lymphoma cells)
Factors associated with worse prognosis:
(1) IPI high risk
(2) bcl-2 positive
Factors associated with a better prognosis:
(1) IPI low
(2) GC phenotype
Parameter
Finding
Points
IPI
0, 1 or 2 (low or low-intermediate risk)
0
>= 3 (high-intermediate or high risk)
1
bcl-2
negative
0
positive
1
GC phenotype
yes
0
no
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• The higher the score the worse the prognossi
Score
5-Year Overall Survival
0 or 1
> 60%
2 or 3
< 35%
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