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dc.titleA 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
dc.contributor.authorLim, R.M.H.
dc.contributor.authorChan, N.P.X.
dc.contributor.authorKhoo, L.P.
dc.contributor.authorCheng, C.L.
dc.contributor.authorTan, L.
dc.contributor.authorPoon, E.Y.L.
dc.contributor.authorSomasundaram, N.
dc.contributor.authorFarid, M.
dc.contributor.authorTang, T.P.L.
dc.contributor.authorTao, M.
dc.contributor.authorLim, S.T.
dc.contributor.authorChan, J.Y.
dc.identifier.citationLim, 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.
dc.description.abstractComposite 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).
dc.publisherNature Research
dc.rightsAttribution 4.0 International
dc.sourceScopus OA2020
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.contributor.departmentDEPT OF PATHOLOGY
dc.description.sourcetitleScientific Reports
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