Bento et al reported a prognostic score for a patient with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP. This can help to identify a patient who may require more aggressive management. The authors are from Grupo Espanol de Linfomas y TrasplanteAutologo (GELTAMO).
Patient selection: diffuse large B-cel lymphoma treated with R-CHOP
Parameters:
(1) age in years
(2) ECOG performance status
(3) clinical stage
(4) bulky mass (> 10 cm in diameter)
(5) serum beta-2 microglobulin (B2M)
(6) lymphocyte to monocyte ratio (LMR)
(7) red cell distribution width ratio (RDW) ratio
Parameter
Finding
Points
age in years
< 60 years
0
60 to 75 years
1
> 75 years
2
ECOG
0, 1 or 2
0
3 or 4
2
stage
I or II
0
III or IV
1
bulky mass
no
0
yes
1
beta-2 microglobulin
low
0
high
1
LMR
<= 2.25
1
> 2.25
0
RDW ratio
<= 0.96
0
> 0.96
1
where:
• The normal RDW is in the range of 12-15%. The paper references the RDW ratio but does not describe its derivation. It could be a ratio of the patient's RDW to the upper limit of normal.
• The concentration for a high B2M is not stated. In the previous GELTAMO score B2M was compared to the upper limit of normal (elevated if greater than the ULN).
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
Total Score
Risk Group
5-Year Overall Survival
0
low
83-100%
1 to 3
low-intermediate
82-84%
4 to 6
intermediate-high
59-63%
7 to 9
high
19-26%
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