International prognostic index-based outcomes for diffuse large B-cell lymphomas (pages 3083–3088)
Richard B. Wilder, Maria A. Rodriguez, L. Jeffrey Medeiros, Susan L. Tucker, Chul S. Ha, Jorge E. Romaguera, Barbara Pro, Mark A. Hess, Fernando Cabanillas and James D. Cox
Version of Record online: 12 JUN 2002 | DOI: 10.1002/cncr.10583
We analyzed outcomes in 224 patients with Stage I–IV diffuse large B-cell lymphoma (DLBCL). Patients participated in two Phase II clinical trials, which included chemotherapy with a median of six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with or without involved-field radiotherapy. Five-year progression-free, cause-specific, and overall survival rates for patients with an international prognostic index (IPI) of 0–2 were 73%, 84%, and 82%, respectively, versus only 37%, 33%, and 32% for patients with an IPI of 3–4. To improve our results, we are currently conducting clinical trials with young DLBCL patients and patients older than 60 years old. The young DLBCL patients, who have more than two adverse prognostic features, are being treated with high-dose chemotherapy and autologous stem cell rescue. The patients older than 60 years, regardless of IPI, are being treated with rituximab immunotherapy and liposomal CHOP chemotherapy with or without involved-field radiotherapy.