A concise prognostic score system for diffuse large B-cell lymphoma: a retrospective study with long-term follow-up.

ABSTRACT

Aim: To identify risk factors and establish a concise prognostic scoring system in patients with diffuse large B-cell lymphoma (DLBCL). Methods: A total of 131 DLBCL patients were enrolled with long-term follow-up who were treated in Shengjing Hospital of the China Medical University. The relationship between clinical parameters and outcomes was analyzed. Results: Multivariate analysis showed that patient age, BMI, CA125 and rituximab application were independent risk factors. Thereafter, a concise scoring system was established, and the new system could identify high-risk patients (p < 0.0001). The patients were divided into three groups low-risk, medium-risk and high-risk groups. There were significant differences among different groups on overall survival and progression-free survival by log-rank test (p < 0.05). Conclusion: Old age, low BMI, high CA125 and no rituximab application were independent risk factors for DLBCL. The new established prognostic score system, which includes all the risk factors, could identify high-risk patients.

Lay abstract Diffuse large B-cell lymphoma (DLBCL) is the most common type of B-cell lymphoma. Different clinical performance and treatment options lead to different outcomes. Identifying factors that indicate poor prognosis is helpful for clinicians to plan a suitable treatment regimen. Therefore, it is important to establish a concise prognostic scoring system to identify high-risk DLBCL patients. This retrospective study analyzed 131 DLBCL patients with long-term follow-up with R-CHOP or E-CHOP therapy regimen. The result showed that patients' age, BMI, CA125 and chemotherapy regimens with or without rituximab were independent risk factors. Thereafter, we established a concise scoring system, which scored each risk factor including old age, low BMI, high CA125 and no rituximab application as 1 point each. Definition of low-risk (0­1 point), medium-risk (2 points) and high-risk (3­4 points) groups indicated significant differences in prognosis.