Prognostic prediction of diffuse large-B-cell lymphoma with International Index (IPI) and enhanced NCCN-IPI

Purpose: We aimed to evaluate the performance of International Index (IPI) and an enhanced NCCN-IPI in prognostic prediction for diffuse large-B-cell lymphom, (DLBCL) and compare these two clinically derived indices. Materials and Methods: Totally 80 patients who were diagnosed as DLBCL from Jan. 2009 to Dec. 2013 were enrolled in this retrospective study and divided into RCHOP group and Non-RCHOP group based on their treatment strategy. Clinical information of these patients was obtained, based on which prognosis of survival was predicted by IPI and NCCN-IPI, respectively. Statistical analyses were performed to evaluate the differences of the potentially influencing factors between RCHOP group and Non-RCHOP group, associated factors of DLBCL prognosis, and prognostic capacity of IPI and NCCN-IPI. Results: Among the included patients, 26 ones received standard RCHOP or RCHOP-like chemotherapy and 54 ones received Non-RCHOP chemotherapy. No significant difference was observed in gender, age, tumor stage, lactate dehydrogenase (LDH) ratio, Eastern Cooperative Oncology Group performance status (ECOG PS), IPI or NCCN-IPI categories (P>0.05) between RCHOP group and Non-RCHOP group. Risk stratifications by IPI and NCCN-IPI were significant different (chi(2) = 16.018, P = 0.001). Compared with original IPI, NCCN-IPI showed more distinctive clinical outcome of overall survival, event-free survival and progression-free survival by Kaplan-Meier curves. Conclusions: The enhanced NCCN-IPI is superior over the traditional IPI for prognostication of the selected cohort of DLBCL patients.