Prognostic models for diffuse large B-cell lymphoma in the rituximab era: a never-ending story
Prognostic models for diffuse large B-cell lymphoma in the rituximab era: a never-ending story
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DOI：
10.1093/annonc/mdp531
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发表时间：
2010-07-01
影响因子：
50.5
通讯作者：
Cox, M. C.
中科院分区：
文献类型：
--
作者：
Bari, A.;Marcheselli, L.;Cox, M. C.
设计和方法：为了评估利妥昔单抗引入前后的国际预后指数（IPI）评分并验证绝对淋巴细胞计数（ALC）/修订的国际预后指数（R-IPI）模型，我们对总共 831 名 DLBCL 患者进行了回顾性分析。结果：我们的结果表明，随着利妥昔单抗的引入，IPI 失去了其区分能力。对第二组的分析使我们能够验证 ALC/R-IPI 模型。 R-IPI 和 ALC/R-IPI 仍可用于设计临床试验，但两者都难以识别高比例的不良预后患者，尽管考虑到挽救治疗对生存的影响不大，这仍然是良好预后模型的一个重要目标。结论：迫切需要一种基于利妥昔单抗时代显着变量并建立在接受利妥昔单抗治疗的患者的大型数据库基础上的新模型。由于预后模型随着所用治疗的功效和作用机制而变化，寻找新的预后评分是一个永无止境的故事，研究人员试图达到一个不断变化的目标。
Design and methods: To evaluate International Prognostic Index (IPI) score before and after rituximab introduction and to validate the absolute lymphocyte count (ALC)/revised International Prognostic Index (R-IPI) model, we carried out a retrospective analysis on a total of 831 patients with DLBCL.Results: Our results show that IPI lost its discriminating power with the introduction of rituximab. The analysis of our second set allowed us to validate the ALC/R-IPI model. The R-IPI and ALC/R-IPI could still be used for designing clinical trials, but both have difficulty recognizing a high percentage of poor prognosis patients, though it remains an important goal of a good prognostic model considering the modest impact of salvage treatments on survival.Conclusions: A new model on the basis of significant variables in the rituximab era and built on a large database of patients treated with rituximab is urgently needed. As prognostic models are changing with the efficacy and mechanisms of action of treatment utilized, looking for a new prognostic score is a never-ending story in which researchers are trying to hit a continuously moving target.