Prognostic indices in diffuse large B-cell lymphoma in the rituximab era: an analysis of the UK National Cancer Research Institute R-CHOP 14 versus 21 phase 3 trial

We compared the International Prognostic Index (IPI), Revised (R)-IPI and age-adjusted (aa)-IPI as prognostic indices for patients with diffuse large B-cell lymphoma (DLBCL) in the UK National Cancer Research Institute (NCRI) R-CHOP 14 versus 21 trial (N = 1080). The R-IPI and aa-IPI showed no marked improvement compared to the IPI for overall and progression-free survival, in terms of model fit or discrimination. Similar results were observed in exploratory analyses incorporating the Grupo Espanol de Linfomas/Transplante de Medula & Oacute; sea (GELTAMO)-IPI, where baseline beta 2-microglobulin data were available (N = 655). Although our findings support current use of the IPI, a novel prognostic tool to better delineate a high-risk DLBCL group in the rituximab era is needed.

Automated summary

The study compared the IPI, R-IPI, and aa-IPI as prognostic indices for DLBCL patients in the UK NCRI trial, finding that R-IPI and aa-IPI did not show significant improvement over IPI in predicting overall and progression-free survival. The study suggests the need for a novel prognostic tool to better identify high-risk DLBCL patients in the rituximab era, despite current support for the use of IPI.