Prognostic value of the absolute lymphocyte count reduction in patients with diffuse large B cell lymphoma treated with R-CHOP.
- Author:
Shi Nae KIM
1
;
Yee Soo CHAE
;
Jong Gwang KIM
;
Joon Ho MOON
;
Soo Jung LEE
;
Yun Jeong KIM
;
Yoo Jin LEE
;
Sang Kyun SOHN
Author Information
1. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. sksohn@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Absolute lymphocyte count;
Rituximab;
DLBCL
- MeSH:
Antibodies, Monoclonal, Murine-Derived;
Cyclophosphamide;
Doxorubicin;
Humans;
L-Lactate Dehydrogenase;
Lymphocyte Count;
Lymphocytes;
Lymphoma, B-Cell;
Retrospective Studies;
Vincristine;
Rituximab
- From:Korean Journal of Medicine
2009;76(1):52-59
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The International Prognostic Index (IPI) and absolute lymphocyte count (ALC) are prognostic factors in diffuse large B cell lymphoma (DLBCL). Nevertheless, in the Rituximab era, a new predictive marker related to Rituximab might be needed. We evaluated prognostic factors for survival in patients with early stage DLBCL after R-CHOP (Rituximab, cyclophosphamide, adriamycin, vincristine, prednisolone) treatment. METHODS: From Aug 2003 to Nov 2007, 78 patients with early stage DLBCL, who finished R-CHOP as scheduled, were reviewed retrospectively. Survival analyses were performed according to clinical parameters (age, performance status, lactate dehydrogenase (LDH), extra-nodal involvement, stage, ALC, and the rates of reduction of the white blood count (WBC) and ALC). RESULTS: Of the 78 patients with early stage DLBCL, 26 (33.3%) were classified as stage I. Seventy-three patients (93.6%) presented with a good performance status, while LDH was elevated in 20 patients (25.6%). According to the IPI, 67 (85.9%), 8 (10.3%), and 3 (3.8%) patients were classified in the low, low-intermediate, and high-intermediate risk groups, respectively. The overall response rate was 100%, including a 94.8% complete response. Survival analysis demonstrated that the rate of reduction of ALC following the first cycle of the R-CHOP regimen was the only factor associated with time-to-progression (p=0.037), whereas age was the single most important prognostic factor for overall survival (p=0.006). CONCLUSIONS: In our study, the rate of reduction of ALC in addition to age and IPI was found to be a significant prognostic factor in patients with early stage DLBCL treated with the R-CHOP regimen.
