Please use this identifier to cite or link to this item: https://doi.org/10.1038/s41598-020-61378-4
Title: A Clinico-Genotypic Prognostic Index for De Novo Composite Diffuse Large B-Cell Lymphoma Arising from Follicular Lymphoma in Asian patients treated in the Rituximab Era
Authors: Lim, R.M.H.
Chan, N.P.X.
Khoo, L.P.
Cheng, C.L. 
Tan, L. 
Poon, E.Y.L.
Somasundaram, N. 
Farid, M. 
Tang, T.P.L. 
Tao, M. 
Lim, S.T. 
Chan, J.Y. 
Issue Date: 9-Mar-2020
Publisher: Nature Research
Citation: Lim, R.M.H., Chan, N.P.X., Khoo, L.P., Cheng, C.L., Tan, L., Poon, E.Y.L., Somasundaram, N., Farid, M., Tang, T.P.L., Tao, M., Lim, S.T., Chan, J.Y. (2020-03-09). A Clinico-Genotypic Prognostic Index for De Novo Composite Diffuse Large B-Cell Lymphoma Arising from Follicular Lymphoma in Asian patients treated in the Rituximab Era. Scientific Reports 10 (1) : 4373. ScholarBank@NUS Repository. https://doi.org/10.1038/s41598-020-61378-4
Rights: Attribution 4.0 International
Abstract: Composite follicular lymphoma with diffuse large B-cell lymphoma (FL/DLBCL) is uncommonly found on lymph node biopsy and represents a rare haematological malignancy. We aim to examine clinico-pathological features of patients with FL/DLBCL and investigate predictors of survival outcome. We included in our retrospective study patients with histologically-proven FL/DLBCL at diagnosis (n = 106) and who were subsequently treated with rituximab-based chemoimmunotherapy from 2002–2017 at the National Cancer Centre. The cohort consisted of 34 women and 72 men with a median age of 59 years (range, 24–82). In a multivariate model inclusive of known clinico-pathological parameters at diagnosis, advanced stage (p = 0.0136), presence of MYC and/or BCL6 rearrangement (p = 0.0376) and presence of B symptoms (p = 0.0405) were independently prognostic for worse overall survival (OS). The only remaining independent prognostic variables for worse OS after including first-line treatment data in the model were use of chemotherapy regimens other than R-CHOP (p = 0.0360) and lack of complete response to chemotherapy (p < 0.0001) besides the presence of B symptoms (p = 0.0022). We generated a Clinico-Genotypic Index by point-wise addition of all five adverse parameters (score of 0–1, 2, 3, 4–5) which revealed four prognostic risk groups with a predicted 5-year OS of 100%, 62%, 40% and 0% (p < 0.0001) accounting for 50.0%, 24.5%, 18.9% and 6.6% of the cohort respectively. We propose that R-CHOP should be the recommended first-line regimen for composite FL/DLBCL. © 2020, The Author(s).
Source Title: Scientific Reports
URI: https://scholarbank.nus.edu.sg/handle/10635/198734
ISSN: 20452322
DOI: 10.1038/s41598-020-61378-4
Rights: Attribution 4.0 International
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