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% |
Specialty: Hematology Oncology