Diffuse large B cell lymphoma natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
The | The prognosis of diffuse large B cell lymphoma is good with treatment. Diffuse large B cell lymphoma is associated with a 5 year survival rate ranging from 70% to more than 90% among children. | ||
==Prognosis== | ==Prognosis== | ||
Several subtypes of diffuse large B cell lymphoma have been identified, each having a different clinical presentation and prognosis. However, the usual treatment for each of these is [[chemotherapy]], often in combination with an antibody targeted at the tumour cells.The IPI score is used in prognosis in clinical practice.<ref>{{cite journal |doi=10.1056/NEJM199309303291402 |pmid=8141877 |title=A Predictive Model for Aggressive Non-Hodgkin's Lymphoma |journal=New England Journal of Medicine |volume=329 |issue=14 |pages=987–94 |year=1993 }}</ref> | Several subtypes of diffuse large B cell lymphoma have been identified, each having a different clinical presentation and prognosis. However, the usual treatment for each of these is [[chemotherapy]], often in combination with an antibody targeted at the tumour cells.The IPI score is used in prognosis in clinical practice.<ref>{{cite journal |doi=10.1056/NEJM199309303291402 |pmid=8141877 |title=A Predictive Model for Aggressive Non-Hodgkin's Lymphoma |journal=New England Journal of Medicine |volume=329 |issue=14 |pages=987–94 |year=1993 }}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The prognosis of diffuse large B cell lymphoma is good with treatment. Diffuse large B cell lymphoma is associated with a 5 year survival rate ranging from 70% to more than 90% among children.
Prognosis
Several subtypes of diffuse large B cell lymphoma have been identified, each having a different clinical presentation and prognosis. However, the usual treatment for each of these is chemotherapy, often in combination with an antibody targeted at the tumour cells.The IPI score is used in prognosis in clinical practice.[1]
- Through these treatments, more than half of patients with diffuse large B cell lymphoma can be cured,[2] and overall survival for older adults at five years is around 58%.[3]
- For children with diffuse large B-cell lymphomas, most studies have found 5-year survival rates ranging from about 70% to more than 90%.[4]
- The Germinal-center subtype has the best prognosis, with 66.6% of treated patients surviving more than five years.[5]
- Lenalidomide has been recently shown to improve outcomes in the Non-germinal center subtype.[6]
International Prognostic Index [7]
- All patients:
- Serum LDH > normal
- Performance status 2-4
- Stage III or IV
- Extranodal involvement >1 site
- International Index,
- All patients
- Low 0 or 1
- Low intermediate 2
- High intermediate 3
- High 4 or 5
Age-Adjusted International Prognostic Index
- Patients <60 YEARS
- Stage III or IV
- Serum LDH > normal
- Performance status 2-4
- International Index,
- Patients < 60 YEARS
- Low/intermediate 1
- High/intermediate 2
- High 3
References
- ↑ "A Predictive Model for Aggressive Non-Hodgkin's Lymphoma". New England Journal of Medicine. 329 (14): 987–94. 1993. doi:10.1056/NEJM199309303291402. PMID 8141877.
- ↑ Akyurek, Nalan; Uner, Aysegul; Benekli, Mustafa; Barista, Ibrahim (2012). "Prognostic significance ofMYC,BCL2, andBCL6rearrangements in patients with diffuse large B-cell lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab". Cancer. 118 (17): 4173–83. doi:10.1002/cncr.27396. PMID 22213394.
- ↑ Feugier, P.; Van Hoof, A; Sebban, C; Solal-Celigny, P; Bouabdallah, R; Fermé, C; Christian, B; Lepage, E; Tilly, H; Morschhauser, F; Gaulard, P; Salles, G; Bosly, A; Gisselbrecht, C; Reyes, F; Coiffier, B (2005). "Long-Term Results of the R-CHOP Study in the Treatment of Elderly Patients with Diffuse Large B-Cell Lymphoma: A Study by the Groupe d'Etude des Lymphomes de l'Adulte". Journal of Clinical Oncology. 23 (18): 4117–26. doi:10.1200/JCO.2005.09.131. PMID 15867204.
- ↑ http://www.cancer.org/Cancer/Non-HodgkinLymphomainChildren/OverviewGuide/non-hodgkin-lymphoma-in-children-overview-survival-rates[full citation needed]
- ↑ http://abstract.asco.org/AbstView_114_99225.html[full citation needed][dead link]
- ↑ Nowakowski, G. S.; Laplant, B.; Macon, W. R.; Reeder, C. B.; Foran, J. M.; Nelson, G. D.; Thompson, C. A.; Rivera, C. E.; Inwards, D. J.; Micallef, I. N.; Johnston, P. B.; Porrata, L. F.; Ansell, S. M.; Gascoyne, R. D.; Habermann, T. M.; Witzig, T. E. (2014). "Lenalidomide Combined with R-CHOP Overcomes Negative Prognostic Impact of Non-Germinal Center B-Cell Phenotype in Newly Diagnosed Diffuse Large B-Cell Lymphoma: A Phase II Study". Journal of Clinical Oncology. 33 (3): 251–7. doi:10.1200/JCO.2014.55.5714. PMID 25135992.
- ↑ "Non-Hodgkin's Lymphomas (NCCN.org)" (PDF).