Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma Journal Article


Authors: Hamlin, P. A.; Zelenetz, A. D.; Kewalramani, T.; Qin, J.; Satagopan, J. M.; Verbel, D.; Noy, A.; Portlock, C. S.; Straus, D. J.; Yahalom, J.; Nimer, S. D.; Moskowitz, C. H.
Article Title: Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma
Abstract: Second-line chemotherapy followed by high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) cures less than half of the patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Prognostic models capable of predicting outcome are essential. In 3 sequential clinical trials, conducted from January 1993 to August 2000, we treated 150 patients with relapsed or primary refractory DLBCL with ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by HDT/ASCT for patients with chemosensitive disease. We evaluated the age-adjusted International Prognostic Index at the initiation of second-line therapy (sAAIPI) as a predictor of progression-free survival (PFS) and overall survival (OS). At a median follow-up of 4 years, the PFS and OS are 28% and 34% by intention to treat and 39% and 45% for only those patients with chemosensitive disease. Three risk groups with different PFS and OS were identified by the sAAIPI: low risk (0 factors), 70% and 74%; intermediate risk (1 factor), 39% and 49%; and high risk (2 or 3 factors), 16% and 18% (P < .001 for both PFS and OS). The sAAIPI also predicts the PFS and OS for patients with ICE-chemosensitive disease: low risk, 69% and 83%; intermediate risk, 46% and 55%; and high risk, 25% and 26% (P < .001 PFS and OS). The sAAIPI predicts outcome for patients with relapsed or primary refractory DLBCL in both intent-to-treat and chemosensitive populations. This powerful prognostic instrument should be used to evaluate new treatment approaches and to compare results of different regimens. © 2003 by The American Society of Hematology.
Keywords: adolescent; adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; survival rate; major clinical study; cancer risk; antineoplastic agents; combined modality therapy; carboplatin; etoposide; antineoplastic combined chemotherapy protocols; risk factors; recurrence; stem cell transplantation; chemosensitivity; ifosfamide; b cell lymphoma; lymphoma, b-cell; predictive value of tests; age distribution; transplantation, autologous; autotransplantation; lymphoma, large-cell, diffuse; humans; prognosis; human; male; female; priority journal; article
Journal Title: Blood
Volume: 102
Issue: 6
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2003-09-15
Start Page: 1989
End Page: 1996
Language: English
DOI: 10.1182/blood-2002-12-3837
PUBMED: 12676776
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. Joachim Yahalom
    394 Yahalom
  2. Carol Portlock
    178 Portlock
  3. Craig Moskowitz
    371 Moskowitz
  4. Ariela Noy
    204 Noy
  5. Jaya M Satagopan
    137 Satagopan
  6. Jing Qin
    86 Qin
  7. David A Verbel
    20 Verbel
  8. Andrew D Zelenetz
    547 Zelenetz
  9. Stephen D Nimer
    339 Nimer
  10. Paul Hamlin
    170 Hamlin
  11. David J Straus
    205 Straus