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Is it possible to improve prognostic value of NCCN-IPI in patients with diffuse large B cell lymphoma? The prognostic significance of comorbidities

Overview of attention for article published in Annals of Hematology, November 2017
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Title
Is it possible to improve prognostic value of NCCN-IPI in patients with diffuse large B cell lymphoma? The prognostic significance of comorbidities
Published in
Annals of Hematology, November 2017
DOI 10.1007/s00277-017-3170-z
Pubmed ID
Authors

Darko Antic, Jelena Jelicic, Goran Trajkovic, Milena Todorovic Balint, Jelena Bila, Olivera Markovic, Ivan Petkovic, Vesna Nikolic, Bosko Andjelic, Vladislava Djurasinovic, Aleksandra Sretenovic, Mihailo Smiljanic, Vojin Vukovic, Biljana Mihaljevic

Abstract

The prognostic value of the International Prognostic Index (IPI) has been re-evaluated in the rituximab-treated diffuse large B cell lymphoma (DLBCL) patients. Accordingly, National Comprehensive Cancer Network-IPI (NCCN-IPI) has been introduced to estimate prognosis of DLBCL patients. However, comorbidities that frequently affect elderly DLBCL patients were not analyzed. The aim of this study was to evaluate the prognostic significance of comorbidities using Charlson Comorbidity Index (CCI) in 962 DLBCL patients. According to CCI, majority of patients (73.6%) did not have any comorbidity, while high CCI (≥ 2) was observed in 71/962 (7.4%) patients, and in 55/426 (12.9%) of the elderly patients aged ≥ 60 years. When the CCI was analyzed in a multivariate model along with the NCCN-IPI parameters, it stood out as a threefold independent risk factor of a lethal outcome. Also, we have developed a novel comorbidity-NCCN-IPI (cNCCN-IPI) by adding additional 3 points if the patient had a CCI ≥ 2. Four risk groups emerged with the following patient distribution in low, low-intermediate, high-intermediate, and high group: 3.4, 34.3, 49.4, and 12.5%, respectively. The prognostic value of the new cNCCN-IPI was 2.1% improved compared to that of the IPI, and 1.3% improved compared to that of the NCCN-IPI (p < 0.05). This difference was more pronounced in elderly patients, in whom the cNCCN-IPI showed a 5.1% better discriminative power compared to that of the IPI, and 3.6% better compared to the NCCN-IPI. The NCCN-IPI enhanced by the CCI and combined with redistributed risk groups is better for differentiating risk categories in unselected DLBCL patients, especially in the elderly.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 21 100%

Demographic breakdown

Readers by professional status Count As %
Other 4 19%
Student > Master 3 14%
Student > Ph. D. Student 3 14%
Researcher 3 14%
Student > Doctoral Student 2 10%
Other 4 19%
Unknown 2 10%
Readers by discipline Count As %
Medicine and Dentistry 12 57%
Nursing and Health Professions 2 10%
Mathematics 1 5%
Agricultural and Biological Sciences 1 5%
Psychology 1 5%
Other 1 5%
Unknown 3 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 January 2018.
All research outputs
#10,986,110
of 12,362,966 outputs
Outputs from Annals of Hematology
#820
of 1,042 outputs
Outputs of similar age
#298,202
of 355,627 outputs
Outputs of similar age from Annals of Hematology
#19
of 36 outputs
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We're also able to compare this research output to 36 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.