2014
DOI: 10.1182/blood-2013-09-524108
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An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era

Abstract: • The clinically based NCCN-IPI is a robust prognostic tool for the rituximab era that better discriminates low-and high-risk DLBCL patients compared with the IPI.• The NCCN-IPI outperforms the IPI by refined categorization of age and LDH, and the identification of disease involvement at specific extranodal sites. : 96% vs 33%) than the IPI (5 year OS: 90% vs 54%), respectively. When validated using an independent cohort from the British Columbia Cancer Agency (n 5 1138), it also demonstrated enhanced discrimi… Show more

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Cited by 693 publications
(656 citation statements)
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“…This is apparent as patients with an identical IPIaa score may exhibit a marked variability in OS, indicative of significant residual heterogeneity within each IPI category [6]. Efforts to improve the discrimination both within and between IPI categories have focused on the addition of novel prognostic factors [4]. Convergence between the different risk groups in the IPI and the varying outcome observed in patients despite having identical IPI scores highlights the need to search for and identify high risk subgroups in DLBCL.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…This is apparent as patients with an identical IPIaa score may exhibit a marked variability in OS, indicative of significant residual heterogeneity within each IPI category [6]. Efforts to improve the discrimination both within and between IPI categories have focused on the addition of novel prognostic factors [4]. Convergence between the different risk groups in the IPI and the varying outcome observed in patients despite having identical IPI scores highlights the need to search for and identify high risk subgroups in DLBCL.…”
Section: Discussionmentioning
confidence: 99%
“…The International Prognostic Index (IPI) was first developed in 1993 to aid in the risk stratification of patients diagnosed with aggressive non-Hodgkin lymphoma and to facilitate outcome prediction [4]. In the era of R-CHOP treatment, redistribution of the IPI factors into a Revised-IPI provided a more clinically useful means of predicting disease outcome [5].…”
mentioning
confidence: 99%
“…It has since been revised, taking into account the effect of more recent treatments on the natural history of the disease. 2,3 Although attempts have been made to prove the usefulness of the IPI in low-grade lymphoma patients, 4,5 its aptness for other lymphoma subtypes has been questioned. This led to the proposal of lymphoma-specific prognostic indices, the follicular lymphoma international prognostic index (FLIPI and FLIPI2), 6,7 the mantle cell lymphoma international prognostic index (MIPI), 8,9 and others for less common conditions.…”
Section: Introductionmentioning
confidence: 99%
“…[1][2][3] Furthermore, patients with high-risk International Prognostic Index (IPI) have a 5-year progression-free survival (PFS) of only 40% following R-CHOP. 4 Therefore, more intensive treatment protocols, such as high-dose therapy (HDT) and autologous stem cell transplantation (ASCT), have been advocated. 5,6 These, however, are associated with considerable increased cost and toxicity.…”
Section: Introductionmentioning
confidence: 99%