Diffuse large B cell lymphoma natural history, complications and prognosis
Diffuse large B cell lymphoma Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Diffuse large B cell lymphoma natural history, complications and prognosis On the Web |
American Roentgen Ray Society Images of Diffuse large B cell lymphoma natural history, complications and prognosis |
FDA on Diffuse large B cell lymphoma natural history, complications and prognosis |
CDC on Diffuse large B cell lymphoma natural history, complications and prognosis |
Diffuse large B cell lymphoma natural history, complications and prognosis in the news |
Blogs on Diffuse large B cell lymphoma natural history, complications and prognosis |
Directions to Hospitals Treating Diffuse large B cell lymphoma |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2] Anila Hussain, MD [3]
Overview
The prognosis of diffuse large B cell lymphoma depends on the stage of the disease. Diffuse large B cell lymphoma is associated with a 5 year survival rate ranging from 70% to more than 90% among children.
Prognosis
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 (International Prognostic Index) score is used in prognosis in clinical practice.[1][2]
INTERNATIONAL PROGNOSTIC INDEX (IPI) | |||
---|---|---|---|
Interantional Prognostic Index | Estimated 3 year Overall Survival (95% CI) | ||
Risk Factors | Age >60 years | ||
Serum LDH >Normal | |||
Stage III-IV | |||
Performance Status 2-4 | |||
Extranodal Sites >1 | |||
Risk categories | Low | 0-1 | 91(89-94) |
Low Intermediate | 2 | 81(73-86) | |
High Intermediate | 3 | 65(58-73) | |
High | 4-5 | 59(49-69) | |
AGE ADJUSTED INTERNATIONAL PROGNOSTIC INDEX (aaIPI) In Patients < or equal to 60 years | |||
Risk Factors | Serum LDH >Normal | ||
Stage III-IV | |||
Performance Status 2-4 | |||
Risk Categories | Low | 0 | 98(96-100) |
Low Intermediate | 1 | 92(87-95) | |
High Intermediate | 2 | 75(66-82) | |
High | 3 |
- Through the 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
- ↑ "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.
- ↑ Diffuse large B-cell lymphoma (DLBCL):ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up Annals of Oncology 26(Supplement 5):v116–v125,2015 doi:10.1093/annonc/mdv304
- ↑ 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.