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https://doi.org/10.1038/s41598-020-61378-4
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dc.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 | |
dc.contributor.author | Lim, R.M.H. | |
dc.contributor.author | Chan, N.P.X. | |
dc.contributor.author | Khoo, L.P. | |
dc.contributor.author | Cheng, C.L. | |
dc.contributor.author | Tan, L. | |
dc.contributor.author | Poon, E.Y.L. | |
dc.contributor.author | Somasundaram, N. | |
dc.contributor.author | Farid, M. | |
dc.contributor.author | Tang, T.P.L. | |
dc.contributor.author | Tao, M. | |
dc.contributor.author | Lim, S.T. | |
dc.contributor.author | Chan, J.Y. | |
dc.date.accessioned | 2021-08-23T03:22:40Z | |
dc.date.available | 2021-08-23T03:22:40Z | |
dc.date.issued | 2020-03-09 | |
dc.identifier.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 | |
dc.identifier.issn | 20452322 | |
dc.identifier.uri | https://scholarbank.nus.edu.sg/handle/10635/198734 | |
dc.description.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). | |
dc.publisher | Nature Research | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.source | Scopus OA2020 | |
dc.type | Article | |
dc.contributor.department | DUKE-NUS MEDICAL SCHOOL | |
dc.contributor.department | PATHOLOGY | |
dc.description.doi | 10.1038/s41598-020-61378-4 | |
dc.description.sourcetitle | Scientific Reports | |
dc.description.volume | 10 | |
dc.description.issue | 1 | |
dc.description.page | 4373 | |
Appears in Collections: | Staff Publications Elements |
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