Chen et al reported a prognostic model for patients with diffuse large B-cell lymphoma (DLBCL). This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Texas M.D. Anderson Cancer Center in Houston.
Patient selection: diffuse large B-cell lymphoma
Parameters:
(1) serum beta-2-microglobulin concentration (mg/dL) relative to upper limit of normal (ULN)
(2) absolute neutrophil count per µL relative to upper limit of normal (ULN)
(3) absolute monocyte count per µL relative to upper limit of normal (ULN)
(4) ECOG performance status
(5) number of extranodal sites
Parameter
Finding
Points
serum beta-2-microglobulin
<= 0.85 times ULN
0
0.86 to 1.25 times ULN
1
1.26 to 2.25 times ULN
2
> 2.25 times ULN
3
absolute neutrophil count
<= ULN
0
> ULN
1
absolute monocyte count
<= ULN
0
> ULN
1
ECOG performance
0 or 1
0
2 to 4
1
number of extranodal sites
0 or 1
0
>= 2
1
where:
• The authors also used simplified cut-offs for beta-2-microglobulin: 1, 1.5 and 2 times ULN.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the worse the prognosis.
Score
Risk Group
Overall 10-year Survival
0
low1
98%
1
low2
85%
2
intermediate
66%
3 to 5
high1
47%
6 or 7
high2
8%
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