scholarly journals An interdisciplinary intervention is associated with overall improvement of older inpatients in a non-geriatric setting: A retrospective analysis of an observational, longitudinal study with one-year follow up

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Franziska M. Müller ◽  
Anna M. Meyer ◽  
Lena Pickert ◽  
Annika Heeß ◽  
Ingrid Becker ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Prognostic Index ◽  
Standard Of Care ◽  
Risk Groups ◽  
Medium Risk ◽  
Older Inpatients ◽  
Geriatric Intervention ◽  
One Year ◽  
Multimorbid Patients

Older persons often loose independence during hospitalization. This analysis aimed at retrospectively evaluating the effects of a pilot individualized multidimensional intervention (IMI) on the comprehensive geriatric assessment (CGA)-based prognosis of older multimorbid patients in an acute internal medicine setting. Records from 72 patients aged 65 years and above who received the IMI were compared to those from 403 patients who received standard of care (SOC). All patients had undergone the CGA-based Multidimensional Prognostic Index (MPI) calculation on admission and at discharge. Patients were divided into three risk groups according to MPI score: Low-risk (MPI-1, 0-0.33), medium-risk (MPI-2, 0.34-0.66) and high-risk (MPI-3, 0.67-1). From admission to discharge, IMI patients showed significant improvements in their MPI score (P=0.014) and subdomains compared to SOC. This was particularly evident in MPI-2 and MPI-3 as well as in patients with poorer functions on MPI admission subdomains. An early geriatric intervention during hospitalization for disease-specific treatments in internal medicine settings improves overall individual prognosis in older multimorbid patients. Prospective randomized studies are needed to confirm these preliminary retrospective observations.

scholarly journals Association of the Lung Immune Prognostic Index with Immunotherapy Outcomes in Mismatch Repair Deficient Tumors

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3776
Author(s):  
Edouard Auclin ◽  
Perrine Vuagnat ◽  
Cristina Smolenschi ◽  
Julien Taieb ◽  
Jorge Adeva ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Performance Status ◽  
Prognostic Index ◽  
Predictive Marker ◽  
Risk Groups ◽  
Two Factors ◽  
One Year ◽  
Metastatic Sites ◽  
Tumor Types

Background: MSI-H/dMMR is considered the first predictive marker of efficacy for immune checkpoint inhibitors (ICIs). However, around 39% of cases are refractory and additional biomarkers are needed. We explored the prognostic value of pretreatment LIPI in MSI-H/dMMR patients treated with ICIs, including identification of fast-progressors. Methods: A multicenter retrospective study of patients with metastatic MSI-H/dMMR tumors treated with ICIs between April 2014 and May 2019 was performed. LIPI was calculated based on dNLR > 3 and LDH > upper limit of normal. LIPI groups were good (zero factors), intermediate (one factor) and poor (two factors). The primary endpoint was overall survival (OS), including the fast-progressor rate (OS < 3 months). Results: A total of 151 patients were analyzed, mainly female (59%), with median age 64 years, performance status (PS) 0 (42%), and sporadic dMMR status (68%). ICIs were administered as first or second-line for 59%. The most frequent tumor types were gastrointestinal (66%) and gynecologic (22%). LIPI groups were good (47%), intermediate (43%), and poor (10%). The median follow-up was 32 months. One-year OS rates were 81.0%, 67.1%, and 21.4% for good, intermediate, and poor-risk groups (p <0.0001). After adjustment for tumor site, metastatic sites and PS, LIPI remained independently associated with OS (HR, poor-LIPI: 3.50, 95%CI: 1.46–8.40, p = 0.02. Overall, the fast-progressor rate was 16.0%, and 35.7% with poor-LIPI vs. 7.5% in the good-LIPI group (p = 0.02). Conclusions: LIPI identifies dMMR patients who do not benefit from ICI treatment, particularly fast-progressors. LIPI should be included as a stratification factor for future trials.

Estimating life expectancy among older multimorbid adults to personalize preventive care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Gastens ◽  
C Del Giovane ◽  
D Anker ◽  
L Syrogiannouli ◽  
N Schwab ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Screening ◽  
Life Expectancy ◽  
Preventive Care ◽  
Hospital Admissions ◽  
Prognostic Index ◽  
Preventive Treatment ◽  
Prognostic Indices ◽  
Multimorbid Patients

Abstract Background Providing high value care and avoiding care overuse is a challenge among older multimorbid adults. There is evidence on benefits and harms of cancer screening and cardiovascular diseases (CVD) preventive treatment up to the age of 75. However, this evidence is not directly applicable to older multimorbid patients. Because each cancer and CVD preventive care has a specific lagtime to benefit, many guidelines recommend tailoring preventive care according to the estimated life expectancy (LE). However, there is no tool to estimate LE among multimorbid patients. Our objectives are therefore to develop new mortality risk prognostic indices and to derive a new LE estimator, what will help clinicians tailoring preventive care in older multimorbid adults. Methods and Results We conduct a prospective cohort study by extending the follow-up of 822 patients in Bern, Switzerland, included in the OPtimising thERapy to prevent Avoidable hospital admissions in Mulitmorbid older people (OPERAM) study over 3 years. Detailed information about cancer screening and CVD preventive treatment will be collected. We will identify variables independently associated with mortality and weight the variables to create 1 year and 3 year mortality prognostic indices. We will transform the 3 year prognostic index into a LE estimator. Preliminary results will be presented at the congress. Conclusions We will develop the first life expectancy estimator specifically for older multimorbid adults. This tool will help clinicians to tailor cardiovascular and cancer preventive care in older multimorbid adults. Key messages Because of the lagtime to benefit, personalizing preventive care by estimated life expectancy is recommended. We will provide the first life expectancy estimator for older multimorbid adults.

Treatment Outcome and Prognostic Model for Stage IE/IIE Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type: A Retrospective Study in a Cohort of 305 Patients with Long Term Follow-up

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2718-2718
Author(s):  
Yuankai Shi ◽  
Bo Jia ◽  
Xiaohui He ◽  
Youwu Shi ◽  
Mei Dong ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
T Cell ◽  
Prognostic Model ◽  
Prognostic Index ◽  
Risk Groups ◽  
Natural Killer T Cell ◽  
Combined Chemoradiotherapy ◽  
Radiotherapy Alone ◽  
Killer T Cell

Abstract Background Extranodal natural killer/T-cell lymphoma, nasal type (ENKL) is a rare and distinct subtype of non-hodgkin lymphoma (NHL). The frequency was higher in Asia than in western countries and it has become the most common subtype of peripheral T-cell lymphomas in China. The majority of ENKL patients present with early stage. Optimal treatment modalities and prognostic factors for localized ENKL have not been fully defined. This study aimed to evaluate the optimal treatment strategy and prognostic factors for localized ENKL patients. Methods Between 2003 and 2013, three hundred and five patients with stage IE/IIE ENKL were comprehensively analyzed in this study. A total of 180 patients received combined chemoradiotherapy, with 111 patients received radiotherapy alone and 14 patients recieved chemotherapy alone. Chemotherapy regimens include GDP (gemcitabine, cisplatin, and dexamethasone), CHOP (epirubicin, cyclophosphamide, vincristine, and prednisolone) and other regimens. A total dose of 50 Gy to the primary tumor was considered as radical dose for ENKL, and additional 5 to 10 Gy was administered as a boost to the residual disease. Results The complete response (CR) rate for patients received chemoradiotherapy (n=175) was significantly higher than that for patients received radiotherapy alone (n=102) (89.1 % vs.77.5 %, P = 0.009) or chemotherapy alone (n=14) (89.1 % vs.21.4 %, P< 0.001). The median follow up time for all 305 patients was 38.7 (1.1 to 393) months. For 228 stage IE paranasal extension or IIE patients, 3-year overall survival (OS) in combined chemoradiotherapy (n=154), radiotherapy alone (n=60) and chemotherapy alone (n=14) groups were 85.7%, 73.3% and 57.1% respectively (chemoradiotherapy vs. radiotherapy, P=0.003; chemoradiotherapy vs. chemotherapy, P<0.001). For patients received combined chemoradiotherapy, GDP regimen (n=54) (included 10 patients with pegaspargase) could significantly improve 3-year progression-free survival (PFS) compared with CHOP-like (n=110) (included 10 patients with asparaginase) (88.9% vs. 70.9%, P =0.015).Patients received radiotherapy first followed by chemotherapy (n=84) was associated with superior 3-year PFS compared with patients initially received chemotherapy (n=96) (81.0% vs. 69.8%, P=0.034). But for 54 patients received GDP regimen, induction chemotherapy (n=17) could increase 3-year PFS (100.0% vs. 83.8%, P=0.112) and OS (100.0% vs. 86.5%, P=0.180). We identified 3 risk groups based on 3 prognostic factors (stage II, LDH elevated and paranasal extension) with different survival outcomes. The 3-year OS rates were 93.5%, 85.0% and 62.2% respectively for patients with no risk factors, 1 or 2 factors and 3 factors (P<0.001). Conclusions Combined chemoradiotherapy is the most optimal therapy strategy for stage IE paranasal extension or IIE ENKL patients. GDP or combined with pegaspargase regimen shows promising efficacy, significant superior to the traditional CHOP regimen. The sequence of chemotherapy and radiotherapy for patients received novel chemotherapy regimens still needs further assessment in phase 3 clinical trials. We identified 3 risk groups based on 3 prognostic factors (stage II, LDH elevated and paranasal extension) with different survival outcomes and this novel prognostic model may better predict prognosis than previous International Prognostic Index (IPI) and Korean Prognostic Index (KPI) score for ENKL patients with limited stage. Disclosures No relevant conflicts of interest to declare.

Preoperative uracil/tegafur and concomitant radiotherapy in locally advanced rectal (LAR) cancer: Updated results with a median follow-up of 5 years and analysis of prognostic factors (PF)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3573-3573 ◽  
Author(s):  
C. Fernandez-Martos ◽  
I. Romero ◽  
J. Aparicio ◽  
C. Bosch ◽  
R. Girones ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Residual Disease ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Standard Of Care ◽  
Complete Information ◽  
Risk Groups ◽  
Attractive Alternative

3573 Background: Preop chemoradiotherapy (CRT) with CI 5-FU is a standard of care for LAR cancer. Oral fluoropyrimidines, an attractive alternative to intravenous 5-FU, are perceived by patients as more convenient. Methods: We performed a phase II study in patients with potentially resectable tumors, localized in middle or distal rectum, ultrasonographically staged as T3 or T4 or N+ who were treated with UFT (400 mg/m2/d, 5 days a week for 5 weeks) and concomitant RT to the pelvis (45 Gy; 1.8 Gy/d over 5 weeks). Pts underwent surgery 5 to 6 weeks later followed by four cycles of 5-FU/LV (Mayo Clinic Scheme). Early end points of efficacy (pCR, downstaging, sphincter preserving surgery) and toxicity have already been reported (JCO 2004;22:3016). We now present data on secondary objectives (RFS, DFS and OS) and univariate and multivariate analysis of clinical and pathological PF. Results: 94 patients were included and complete information on 88 (94%) is availablewith a median follow-up of 5 years (60.4 months). Actuarial Kaplan-Meier DFS, RFS and OS are 61%, 66%, and 70 %. Patterns of failure are 7% pelvic and 25% distant. Univariate analysis results are shown in the table . Survival rate was also higher among patients with no or few residual disease after CRT but did not reach statistical significance. In Cox multivariate analysis both ypT and ypN are independent PF for DFS and RFS but only ypT is an independent PF for OS. Conclusions: This approach with preop UFT/RT reproduces the results that have been accomplished with 5-FU. ypT and ypN could be helpful to identify different risk groups and to select adjuvant treatments. [Table: see text] No significant financial relationships to disclose.

scholarly journals Pentraxin-3 Levels Relate to the Wells Score and Prognosis in Patients with Acute Pulmonary Embolism

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Haotian Yang ◽  
Jun Zhang ◽  
Ying Huan ◽  
Yawei Xu ◽  
Rong Guo
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Acute Pulmonary Embolism ◽  
Risk Groups ◽  
Low Risk ◽  
Recurrent Pulmonary Embolism ◽  
Medium Risk ◽  
Wells Score ◽  
The Difference

Objective. To investigate the value of the PTX-3 test in evaluating the prognosis of acute pulmonary embolism (APE). Method. 117 APE patients were selected and divided into two groups according to plasma PTX-3 levels, including the group in which PTX−3≥3.0 ng/mL (n=42) and the group in which PTX−3<3.0 ng/mL (n=75). Patients were stratified into high-risk, medium-risk, and low-risk groups according to the Wells scores, and the PTX-3 levels were compared among the groups. Patients had been followed-up as well. Results. According to the Wells scores, 11 patients were classified as high-risk (9.4%) and 68 were medium-risk (58.1%), while 38 were low-risk (32.5%). The PTX-3 levels in different risk groups were statistically different (all P<0.05). During the follow-up period, 6 deaths occurred in the group with elevated PTX-3 (≥3.0 ng/mL), while 2 deaths occurred in the group with nonelevated PTX-3 (<3.0 ng/mL). The difference between the two groups was statistically significant (P<0.01). 13 patients were hospitalized due to recurrent pulmonary embolism, of which 12 were in the group with elevated PTX-3 (≥3.0 ng/mL), while 1 patient was in the group with nonelevated PTX-3 (<3.0 ng/mL). The difference was statistically significant (P<0.01). Conclusion. The plasma PTX-3 level in APE patients is correlated with PE risk stratification. There is a significant correlation between PTX-3 levels and PE-related cardiac deaths, as well as the prognosis of recurrent PE. PTX-3 can be used as a clinical indicator of PE prognosis.

The Multidimensional Prognostic Index in general practice: One‐year follow‐up study

2019 ◽  
Vol 73 (12) ◽  
Author(s):  
Anna Maria Meyer ◽  
Giacomo Siri ◽  
Ingrid Becker ◽  
Thomas Betz ◽  
August W. Bödecker ◽  
...  
Keyword(s):  
General Practice ◽  
Prognostic Index ◽  
Follow Up Study ◽  
One Year

CARMENA: Cytoreductive nephrectomy followed by sunitinib versus sunitinib alone in metastatic renal cell carcinoma—Results of a phase III noninferiority trial.

2018 ◽  
Vol 36 (18_suppl) ◽  
pp. LBA3-LBA3 ◽  
Author(s):  
Arnaud Mejean ◽  
Bernard Escudier ◽  
Simon Thezenas ◽  
Jean-Baptiste Beauval ◽  
Lionnel Geoffroy ◽  
...  
Keyword(s):  
Standard Of Care ◽  
Risk Groups ◽  
Phase Iii ◽  
Routine Practice ◽  
Cytoreductive Nephrectomy ◽  
Phase Iii Trial ◽  
Significance Level ◽  
Dose Adaptation ◽  
Ecog Ps

LBA3 Background: Cytoreductive nephrectomy (CN) has been the standard of care in mRCC in the past twenty years, supported by randomized and large retrospective studies. However the efficacy of targeted therapies has challenged this standard. CARMENA was designed to answer the question of whether upfront CN should continue to be performed before sunitinib. Methods: CARMENA was a randomized phase III trial. Patients (pts) with synchronous mRCC, amenable to CN, were enrolled after confirmation of clear cell histology on biopsy if PS 0-1, absence of symptomatic brain metastasis, acceptable organ function and eligible for sunitinib therapy. Pts were randomized 1:1 to either CN followed by sunitinib (arm A) or sunitinib alone (arm B), and stratified by MSKCC risk groups. Sunitinib was given at 50 mg/d, 4/6wk with dose adaptation to routine practice. In arm A, sunitinib had to start 4 to 6 wk after surgery. Primary endpoint was overall survival (OS). A total of 576 pts had to be enrolled to demonstrate non inferiority hypothesis (H0: λE/λC > 1.20), with 80% power at a 1-sided significance level of 5%. Results: 450 pts were included from 9/09 to 9/17, 226 and 224 in arm A and B, respectively. Median age was 62, ECOG-PS was 0 in 56% and 1 in 44%. MSKCC risk groups were intermediate/poor in 55.6/44.4% (arm A) and in 58.5/41.5% (arm B). In arm A, 6.7% did not have CN and 22.5% never received sunitinib. In arm B, 4.9 % never received sunitinib and 17% had secondary nephrectomy. At the time of the analysis, 326 deaths have been observed with a median follow-up of 50.9 mo. OS was not inferior in arm B, overall as well as by MSKCC risk groups (table). No difference in response rate and PFS was observed. Safety of sunitinib was as expected in both arms. Conclusions: Sunitinib alone is not inferior to CN followed by sunitinib in synchronous mRCC both in intermediate and poor MSKCC risk groups. CN should not be anymore the standard of care when medical treatment is required. Clinical trial information: NCT00930033. [Table: see text]

scholarly journals Code Status Discussion Skill Retention in Internal Medicine Residents: One-Year Follow-Up

2012 ◽  
Vol 15 (12) ◽  
pp. 1325-1328 ◽  
Author(s):  
Diane B. Wayne ◽  
Farzad Moazed ◽  
Elaine R. Cohen ◽  
Rashmi K. Sharma ◽  
William C. McGaghie ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Skill Retention ◽  
Code Status ◽  
Internal Medicine Residents ◽  
One Year

Autologous Stem Cell Transplantation Is Feasible and of Potential Benefit In Very Elderly Patients with Lymphoma and Limited Comorbidities

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3561-3561
Author(s):  
Rebecca Elstrom ◽  
Peter Martin ◽  
Tsiporah B. Shore ◽  
Richard R. Furman ◽  
Jia Ruan ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Elderly Patients ◽  
Clinical Research ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Research Funding ◽  
Medium Risk ◽  
One Year

Abstract Abstract 3561 Introduction: In patients with Hodgkin lymphoma (HL) and non-Hodgkin's lymphoma (NHL) for whom initial therapy is not curative, high dose chemotherapy followed by autologous stem cell transplantation (AutoSCT) may offer a second chance for cure or long term remission. Because of the potential toxicities of this therapy, elderly patients are usually not considered candidates for this approach. Although recent publications have suggested that AutoSCT may benefit some patients over 65 years of age, data regarding feasibility in older patients (69 or greater) are lacking. Patients and Methods: The stem cell transplant database at Weill Cornell Medical College was reviewed to identify patients with a diagnosis of lymphoma (HL or NHL) age 69 or greater who had undergone AutoSCT. Patients were included if age, date of transplant, response and survival data were available. Baseline Charlson comorbidity risk index (CCI) was calculated and correlated with outcome. Results: Twenty-one patients aged 69 or greater (range 69–86, median 71) with adequate records were identified who underwent autologous stem cell transplantation for treatment of lymphoma. Thirteen patients had diffuse large B cell lymphoma, 3 had transformed indolent lymphoma, 2 had Burkitt lymphoma, one had peripheral T cell lymphoma, one had follicular lymphoma, and one had HL. Sixteen patients underwent AutoSCT in first relapse with chemotherapy sensitive disease, 2 patients had primary refractory lymphoma, 2 were in 2nd or greater relapse, and one patient was in first complete remission (CR). Two patients underwent total body irradiation (TBI) as part of conditioning, while the other 19 patients underwent conditioning with chemotherapy alone. Sixteen patients (76%) achieved CR following autoSCT, while 3 patients did not achieve CR; 2 patients died before response assessment could be undertaken. With median follow up of 20 months, the median progression-free survival following autoSCT was 10 months and median overall survival was 18 months. Age was associated with PFS (HR 1.18, p=0.05, 95% C.I. 1.05–1.33) but not OS (HR 1.11, p=0.09, 95% C.I. 0.98–1.25). Eight of 18 patients with adequate follow up (44%) remained in remission for at least 18 months post-transplant. CCI data were available for 19 patients. Four patients (19%) died within or shortly after 100 days, all of transplant-related toxicity. Two of these 4 patients were high risk by CCI, one was medium risk, and CCI data were not available for the fourth patient. Three other patients were of medium risk; 2 are alive in CR and one died of progressive lymphoma 19 months after transplantation. Thirteen patients were of low risk by CCI. Of these patients, 9 (69%) are either alive at time of follow up or survived for greater than one year after transplant, while 4 (31%) died within one year of progressive lymphoma. Conclusion: Autologous stem cell transplantation is feasible and of potential benefit in selected elderly patients with lymphoma. Age alone need not exclude patients with good functional status and limited comorbidity from this therapeutic approach. Consideration of comorbidities may allow selection of patients most likely to tolerate and benefit from AutoSCT. Disclosures: Furman: GlaxoSmithKline: Clinical research funding, Consultancy, Research Funding, Speakers Bureau; Genentech: Clinical Research Funding, Consultancy, Research Funding, Speakers Bureau; Cephalon: Speakers Bureau, Speakers bureau; Calistoga: Consultancy, Honoraria; Celgene: Clinical Research, Consultancy, Research Funding. Leonard:Hospira: Consultancy, Honoraria; Cell Therapeutics: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria; Celgene: Consultancy, Honoraria; GlaxoSmithKline: Consultancy, Honoraria; Biogen IDEC: Consultancy, Honoraria; Calistoga: Consultancy, Honoraria; Johnson and Johnson: Consultancy, Honoraria; EMD Serono: Consultancy, Honoraria; Sanofi Aventis: Consultancy, Honoraria; Millenium: Consultancy, Honoraria; Biotest: Consultancy, Honoraria; Cephalon: Consultancy, Honoraria; Pharmion: Consultancy, Honoraria; Eisai: Consultancy, Honoraria; Cougar Biotechnology: Consultancy, Honoraria; Immunomedics: Honoraria; Genentech: Consultancy, Honoraria; Novartis: Consultancy, Honoraria.

Comparison of the international prognostic factors index (IPI) with the absolute monocyte and lymphocyte prognostic index (AMLPI) for patients (Pts) with diffuse large b-cell lymphoma (DLBCL) receiving R-CHOP.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8067-8067
Author(s):  
Nicolas Batty ◽  
Elham Ghonimi ◽  
Lei Feng ◽  
Luis Fayad ◽  
Anas Younes ◽  
...  
Keyword(s):  
High Risk ◽  
Cell Lymphoma ◽  
Univariate Analysis ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Risk Groups ◽  
Prognostic Effect ◽  
Large B Cell Lymphoma ◽  
High Risk Disease

8067 Background: We studied the value of a proposed prognostic index (PI) generated by baseline absolute monocyte (AMC) and lymphocyte (ALC) counts for pts with DLBCL, using values as previously reported (Leukemia 25:1502-9, 2011). Methods: From 03/07 to 01/09, 245 consecutive pts with untreated DLBCL receiving standard R-CHOP from the MDACC database were evaluated. Baseline AMC and ALC were retrospectively recorded. High AMC (≥610/uL) and a low ALC (≤1000/uL) were examined as dichotomized variables for progression-free (PFS) and overall survival (OS). An AMLPI was generated, stratifying pts into 3 risk groups (RGs): low-(AMC <610/uL and ALC >1000/uL), intermediate-(AMC ≥610/uL or ALC ≤1000/uL), and high-risk(AMC ≥610/uL and ALC ≤1000/uL). The prognostic effect of the AMLPI and the IPI were examined by multivariate analysis (MVA). Results: Ninety (37%) had high AMC and 71 (29%) had low ALC. By univariate analysis, a high AMC was associated with inferior PFS (p=0.01) and OS (p=0.03). The frequencies of AMLPI RGs were: low-105 pts (43%), intermediate-119 (48%), and high risk-21 (9%). With a median follow-up of 22 months (range <1-42), 3-year PFS and OS rates for these RGs were 80%, 61%, and 46% (p=0.007) and 92%, 76%, and 60% (p=0.006), respectively. Three-year PFS rates for IPI 0-2 and 3-5 RGs were 73% and 58%, respectively (p=0.0004); comparable OS rates were 88% and 68%(p<0.0001). For pts with IPI 0-2, 1-year PFS rates for AMLPI low, intermediate, and high RGs were 92%, 89% and 80% (p=0.022); comparable 1-year OS rates were 96%, 95% and 80% (p=0.049). By MVA, AMLPI effect (low vs. high RGs) on PFS was significant (p=0.046) as was IPI effect (0-2 vs 3-5, p=0.005); similar results were observed for OS (p=0.052 and p=0.003, respectively). Conclusions: Baseline AMC and AMLPI are significant variables for PFS and OS for pts with DLBCL receiving R-CHOP. AMLPI can identify pts with low, intermediate, and high-risk disease for PFS and OS, particularly for those with IPI 0-2. AMLPI may also add prognostic value beyond that of the IPI.

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