Shipp et al evaluated 121 patients with diffuse large cell lymphoma who were treated with b-BACOD or M-BACOD (methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine and dexamethasone). Patients could be separated into risk groups based on clinical findings, which correlated with survival. The authors are from Dana Farber Cancer Institute and Brigham and Women's Hospital in Boston.
Parameters:
(1) ECOG performance status
(2) diameter of largest tumor focus, as a marker for bulky disease
(3) number of extranodal sites
|
Parameter |
Finding |
Points |
|
Performance status |
0 or 1 |
0 |
|
|
2 to 4 |
1 |
|
diameter of largest tumor focus |
< 10 cm |
0 |
|
|
>= 10 cm |
1 |
|
number of extranodal sites |
0 |
0 |
|
|
1 |
1 |
|
|
>= 2 |
2 |
Based on the different patterns for these markers:
|
Performance |
Diameter |
Extranodal |
log hazard ratio |
Risk Group |
|
0 |
0 |
0 |
0 |
low |
|
0 |
0 |
1 |
0.48 |
low |
|
0 |
0 |
2 |
0.96 |
moderate |
|
0 |
1 |
0 |
0.82 |
moderate |
|
0 |
1 |
1 |
1.30 |
moderate |
|
0 |
1 |
2 |
1.78 |
high |
|
1 |
0 |
0 |
1.88 |
high |
|
1 |
0 |
1 |
2.36 |
high |
|
1 |
0 |
2 |
2.83 |
high |
|
1 |
1 |
0 |
2.70 |
high |
|
1 |
1 |
1 |
3.18 |
high |
|
1 |
1 |
2 |
3.66 |
high |
from Figure 2, page 763
According to the legend to Figure 2, the log hazard ratio can be given as:
log hazard ratio =
= (2.071 * (points for performance status)) + (0.747 * (points for diameter)) + (0.695 * (points for extranodal sites))
If you look at the data in the table the coefficient for the performance status should be 1.88, for diameter 0.82 and for extranodal sites 0.48. These are the coefficients given in Table 3 for survival (page 760).
|
Risk Group |
5 Year Survival |
|
low |
68% |
|
moderate |
55% |
|
high |
24% |
Specialty: Hematology Oncology
ICD-10: ,
