Differential prognostic impact of GELTAMO‐IPI in cell of origin subtypes of Diffuse Large B Cell Lymphoma as defined by the Hans algorithm

Abstract

The Grupo Español de Linfomas y Trasplantes de Médula Ósea International Prognostic Index (GELTAMO-IPI) stratifies four risk groups in diffuse large B cell lymphoma (DLBCL) patients treated with immunochaemotherapy: low (LR), low-intermediate (LIR), high-intermediate (HIR), and high (HR). The present study explores the effect of GELTAMO-IPI in the DLBCL subtypes defined by the immunohistochaemistry-based Hans algorithm, Germinal Centre B (GCB) and non-GCB. A multivariate Cox regression model including GELTAMO-IPI risk groups, cell of origin (COO) subtypes and their product was developed to evaluate interaction between the two variables. The COO subtype was available in 839 patients (380 GCB; 459 non-GCB) and both the GELTAMO-IPI and the COO subtype in 780 (353 GCB; 427 non-GCB). There were no differences in 5-year overall survival (OS) between the two subtypes. The Cox model revealed interaction between the GELTAMO-IPI risk groups and the COO subtypes (P = 0·005), indicating that GELTAMO-IPI has a different effect in the two subtypes. Three risk groups were stratified in both COO subtypes: in the GCB subtype, LR, LIR and the combined HIR+HR had 5-year OS of 100%, 75% and 52%, respectively. In the non-GCB subtype, LR, the combined LIR+HIR and HR had a 5-year OS of, 97%, 82% and 35% respectively. GELTAMO-IPI identifies a genuine poor outcome group of patients in the DLBCL non-GCB subtype.

Value of total lesion glycolysis and cell-of-origin subtypes for prognostic stratification of diffuse large B-cell lymphoma patients

“…Participants with a non-GCB phenotype were at a (18,26). Cell-oforigin subtypes defined by the IHC-based Hans algorithm could even discriminate very high-risk patients (27). Furthermore, in Toledano et al's study (28), the combination of TMTV and cell-of-origin subtypes could allow for significantly better risk stratification of patients with DLBCL in terms of both PFS and OS.…”

Treatment of refractory diffuse large B-cell lymphoma by chidamide combined with autologous stem cell transplantation: a case report

“…Why was the patient’s disease refractory? The IPI scoring system stratified DLBCL by clinical factors, the high-risk group suggested poor clinical prognosis [10], and our patient was in the high to intermediate group. When treated with standard chemotherapy, ABC DLBCL is associated with poor outcomes and double-expressor lymphomas, which overexpress MYC and BCL2 proteins, are also associated with poor prognoses [11].…”

High pretreatment plasma D-dimer levels predict poor survival in patients with diffuse large B-cell lymphoma in the real world

“…Meanwhile, the (23,24). Other researchers added some clinicopathological characteristics to IPI to constitute new prognostic indicators (25)(26)(27). However, the efficiencies of these new indicators in prognostic prediction remain controversial (25,(28)(29)(30)(31).…”

“…Thus, experts modified the IPI to R-IPI and NCCN-IPI by adjusting or refining factors included previously ( 23 , 24 ). Other researchers added some clinicopathological characteristics to IPI to constitute new prognostic indicators ( 25 - 27 ). However, the efficiencies of these new indicators in prognostic prediction remain controversial ( 25 , 28 - 31 ).…”