A new prognostic score for elderly patients with diffuse large B-cell lymphoma treated with R-CHOP: the prognostic role of blood monocyte and lymphocyte counts is absent

• Published in: PloS one 2014-07, Vol.9 (7), p.e102594
• Main Authors: Procházka, Vít, Pytlík, Robert, Janíková, Andrea, Belada, David, Sálek, David, Papajík, Tomáš, Campr, Vít, Fürst, Tomáš, Furstova, Jana, Trněný, Marek
• Format: Article
• Language: English
• Subjects: Age; Age Factors; Aged; Aged, 80 and over; Analysis; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; B-cell lymphoma; Biomarkers - analysis; Cancer; Care and treatment; Cell number; Cell survival; Chemotherapy; Cyclophosphamide - administration & dosage; Dentistry; Doxorubicin - administration & dosage; Elderly patients; Female; Geriatrics; Hematology; Hospitals; Humans; Internal medicine; Leukocyte Count; Lymphocytes; Lymphocytes - pathology; Lymphocytes B; Lymphoma; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - mortality; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphomas; Male; Medical diagnosis; Medical prognosis; Medicine; Medicine and health sciences; Middle Aged; Monocytes; Monocytes - pathology; Multivariate analysis; Older people; Patients; Population (statistical); Predictions; Prednisone - administration & dosage; Prognosis; Research Design - statistics & numerical data; Retrospective Studies; Risk analysis; Risk Factors; Risk groups; Statistical analysis; Studies; Survival; Survival Analysis; Vincristine - administration & dosage
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0102594

Absolute lymphocyte count (ALC) and absolute monocyte count (AMC) have been documented as independent predictors of survival in patients with newly diagnosed Diffuse Large B-cell Lymphoma (DLBCL). Analysis of the prognostic impact of ALC and AMC in the context of International Prognostic Index (IPI) and other significant variables in elderly population treated in the R-CHOP regime has not been carried out yet. In this retrospective study, a cohort of 443 newly diagnosed DLBCL patients with age ≥ 60 was analyzed. All patients were treated with the R-CHOP therapy. An extensive statistical analysis was performed to identify risk factors of 3-year overall survival (OS). In multivariate analysis, only three predictors proved significant: Eastern Cooperative Oncology Group performance status (ECOG), age and bulky disease presence. These predictors were dichotomized (ECOG ≥ 1, age ≥ 70, bulk ≥ 7.5) to create a novel four-level score. This score predicted 3-year OS of 94.0%, 77.4%, 62.7% and 35.4% in the low-, low-intermediate, high-intermediate and high-risk groups, respectively (P