Diffuse large B cell lymphoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Prognosis
A scoring system, known as the International Prognostic Index (IPI), gives one point for each of the above characteristics, for a total score ranging from zero to five, representing three risk groups [1]
- Low risk, IPI score of 0 or 1 (91 percent of people in this risk group are still alive at three years)
- Low to intermediate risk, IPI score of 2 (81 percent of people in this risk group are still alive at three years)
- High to intermediate risk, IPI score of 3 (65 percent of people in this risk group are still alive at three years)
- High risk, IPI score of 4 or more (59 percent of people in this risk group are still alive at three years)
Several subtypes of Diffuse large B cell lymphoma have been identified, each having a different clinical presentation and prognosis. However, the usual treatment for each of these is chemotherapy, often in combination with an antibody targeted at the tumour cells.The IPI score is used in prognosis in clinical practice.[2]
- Through these treatments, more than half of patients with Diffuse large B cell lymphoma can be cured,[3] and overall survival for older adults at five years is around 58%.[4]
- For children with diffuse large B-cell lymphomas, most studies have found 5-year survival rates ranging from about 70% to more than 90%.[5]
- The Germinal-center subtype has the best prognosis, with 66.6% of treated patients surviving more than five years.[6]
- Lenalidomide has been recently shown to improve outcomes in the Non-germinal center subtype.[7]
References
- ↑ Ziepert M, Hasenclever D, Kuhnt E, Glass B, Schmitz N, Pfreundschuh M; et al. (2010). "Standard International prognostic index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era". J Clin Oncol. 28 (14): 2373–80. doi:10.1200/JCO.2009.26.2493. PMID 20385988.
- ↑ "A Predictive Model for Aggressive Non-Hodgkin's Lymphoma". New England Journal of Medicine. 329 (14): 987–94. 1993. doi:10.1056/NEJM199309303291402. PMID 8141877.
- ↑ Akyurek, Nalan; Uner, Aysegul; Benekli, Mustafa; Barista, Ibrahim (2012). "Prognostic significance ofMYC,BCL2, andBCL6rearrangements in patients with diffuse large B-cell lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab". Cancer. 118 (17): 4173–83. doi:10.1002/cncr.27396. PMID 22213394.
- ↑ Feugier, P.; Van Hoof, A; Sebban, C; Solal-Celigny, P; Bouabdallah, R; Fermé, C; Christian, B; Lepage, E; Tilly, H; Morschhauser, F; Gaulard, P; Salles, G; Bosly, A; Gisselbrecht, C; Reyes, F; Coiffier, B (2005). "Long-Term Results of the R-CHOP Study in the Treatment of Elderly Patients with Diffuse Large B-Cell Lymphoma: A Study by the Groupe d'Etude des Lymphomes de l'Adulte". Journal of Clinical Oncology. 23 (18): 4117–26. doi:10.1200/JCO.2005.09.131. PMID 15867204.
- ↑ http://www.cancer.org/Cancer/Non-HodgkinLymphomainChildren/OverviewGuide/non-hodgkin-lymphoma-in-children-overview-survival-rates[full citation needed]
- ↑ http://abstract.asco.org/AbstView_114_99225.html[full citation needed][dead link]
- ↑ Nowakowski, G. S.; Laplant, B.; Macon, W. R.; Reeder, C. B.; Foran, J. M.; Nelson, G. D.; Thompson, C. A.; Rivera, C. E.; Inwards, D. J.; Micallef, I. N.; Johnston, P. B.; Porrata, L. F.; Ansell, S. M.; Gascoyne, R. D.; Habermann, T. M.; Witzig, T. E. (2014). "Lenalidomide Combined with R-CHOP Overcomes Negative Prognostic Impact of Non-Germinal Center B-Cell Phenotype in Newly Diagnosed Diffuse Large B-Cell Lymphoma: A Phase II Study". Journal of Clinical Oncology. 33 (3): 251–7. doi:10.1200/JCO.2014.55.5714. PMID 25135992.
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