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논문 기본 정보

자료유형
학술저널
저자정보
Naree Warnnissorn (Department of Pathology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand) Nonglak Kanitsap (Division of Hematology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand) Pimjai Niparuck (Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand) Paisarn Boonsakan (Department of Pathology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand) Prapasri Kulalert (Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand) Wasithep Limvorapitak (Division of Hematology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand) Lantarima Bhoopat (Division of Hematology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand) Supawee Saengboon (Division of Hematology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand) Chinnawut Suriyonplengsaeng (Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand) Pichika Chantrathammachart (Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand) Teeraya Puavilai (Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand) Suporn Chuncharunee (Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand)
저널정보
대한혈액학회 Blood Research Blood Research Vol.59 No.1
발행연도
2024.3
수록면
2 - 2 (1page)
DOI
10.1007/s44313-024-00006-w

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초록· 키워드

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Background MYC/BCL2 double expression (DE) is associated with poor prognosis in patients with diffuse large B-cell lymphoma (DLBCL) receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). This study aimed to determine whether the addition of DE to the National Comprehensive Cancer Network Internal Prognostic Index (NCCN-IPI) could improve the prediction of disease progression in patients with DLBCL treated with R-CHOP. Methods This confirmatory prognostic factor study retrospectively recruited patients with newly diagnosed DLBCL between January 1, 2014, and January 31, 2018, at Ramathibodi Hospital (RA) and Thammasat University Hospital (TU). The follow-up period ended on July 1, 2022. Tumors expressing MYC ≥ 40% and BCL2 ≥ 50% were classified as DE. We calculated the hazard ratios (HR) for progression-free survival (PFS) from the date of diagnosis to refractory disease, relapse, or death. Discrimination of the 5-year prediction was based on Cox models using Harrell’s concordance index (c-index). Results A total of 111 patients had DE (39%), NCCN-IPI (8%), and disease progression (46%). The NCCN-IPI adjusted HR of DE was 1.6 (95% confidence interval [CI]: 0.9–2.8; P = 0.117). The baseline NCCN-IPI c-index was 0.63. Adding DE to the NCCN-IPI slightly increased Harrell’s concordance index (c-index) to 0.66 (P = 0.119). Conclusions Adding DE to the NCCN-IPI may not improve the prognostic value to an acceptable level in resourcelimited settings. Multiple independent confirmatory studies from a large cohort of lymphoma registries have provided additional evidence for the clinical utility of DE.

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