Candelaria et al reported a prognostic score for a patient with diffuse large B-cell lymphoma. This can help to identify a patient who may benefit from more aggressive management, the authors are from the Instituto Nacional de Cancerologia in Mexico City.
Patient selection: diffuse large B-cell lymphoma (DLBCL) with age >= 65 years
Parameters:
(1) serum beta-2-microglobulin compared to the upper limit of normal (ULN), with reference range 1.4 to 2.5 mg/L
(2) bulky disease (diameter > 7 cm)
(3) hemoglobin in g/dL (indicative of anemia)
(4) ECOG performance status
Parmeter
Finding
Points
beta-2-microglobulin
<= ULN
1
> ULN
2
ECOG
0 or 1
1
2
2
3
3
bulky disease
<= 7 cm
1
> 7 cm
2
hemoglobin
>= 10 g/dL
1
< 10 g/dL
2
where:
• ECOG 4 was not specified in scoring. A patient with ECOG 4 would be high risk.
• ECOG 0 was not specified. Since each parameter had a minimum score of 1 it was assigned with 1.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 4
• maximum score: 9
• The higher the score the worse the prognosis.
Total Score
Risk
3-Year Survival
4 or 5
low
80%
6
intermediate
56%
7, 8 or 9
high
20%
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