Validation of the International Prognostic Index in Working Formulation group A low-grade non-Hodgkin's lymphoma: retrospective analysis of 137 patients from the Gruppo Italiano per lo Studio dei Linfomi registry

Citation
C. Stelitano et al., Validation of the International Prognostic Index in Working Formulation group A low-grade non-Hodgkin's lymphoma: retrospective analysis of 137 patients from the Gruppo Italiano per lo Studio dei Linfomi registry, HAEMATOLOG, 85(2), 2000, pp. 154-159
Citations number
16
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Hematology Research
Journal title
HAEMATOLOGICA
ISSN journal
0390-6078 → ACNP
Volume
85
Issue
2
Year of publication
2000
Pages
154 - 159
Database
ISI
SICI code
0390-6078(200002)85:2<154:VOTIPI>2.0.ZU;2-9
Abstract
Background and Objectives. The subset of non-follicular non-Hodgkin's lymph oma (NHL) includes patients with varied prognoses, thus suitable for differ ent therapeutic approaches. The International Prognostic index (IPI), origi nally proposed for aggressive NHL, has been demonstrated to be of prognasti c relevance also in follicular NHL, The main aim of the study was to valida te the IPI in this histologic category; in addition, the specific prognosti c classification, currently employed in the Gruppo Italiano per lo Studio d ei Linfoml (GISL) prospective therapeutic trials and based on different fea tures, more similar to those applied to chronic lymphocytic leukemia, was a nalyzed. Design and Methods, The present series consists of 137 evaluable patients a ffected by Working Fomrulation group A NHL out of 256 cases referred to the GISL Registry. The retrospective prognostic study included the evaluation by bath univariate and multivariate analyses of overall survival, response to therapy and response duration. The IPI was applied as originally propose d. The GISL definition of Indolent and aggressive disease at diagnosis was based on the presence of B symptoms, bulky disease, anemia and thrombocytop enia. Results. The distribution of patients In IPI risk groups was rather unbalan ced with 18%, 47%, 28% and 7% of cases classified as low (L), intermediate- low (IL), intermediate-high (IH) and high (H) risk, respectively. The media n overall survival was not reached In either L or IL risk groups, and was 8 4.1 and 7.4 months for IH and H risk groups, respectively (p=0.0005). A sim plified IPI model was designed merging patients in both intermediate risk g roups and the statistical difference of survival retained its significance. GISL prognostic stratification was demonstrated to have a Significant asso ciation with survival, with a median survival of 71.3 months In aggressive disease and a median survival not reached at 152 months In Indolent disease . Both the simplified IPI model and the GISL risk definition retained their significance In multivariate analysis for overall survival, while for resp onse to therapy only the simplified IPI model resulted to be of stattistica l significance. In addition, the GISL prognostic stratification identified patients with different outcomes within the IPI intermediate risk group, wi th a median survival of 70.2 months for patients with aggressive disease wh eras the median survival for those with Indolent disease was not reached. F inally, a prognostic score resulting from the Integration of the simplified IPI and the GISL system was statistically validated. Interpretation and Conclusions. The retrospective analysis of this series d emonstrates the validity of the IPI in non-follicular Indolent NHL and the usefulness of integrating the IPI parameters with disease specific prognost ic variables. (C) 2000, Ferrata Storti Foundation.