Group risk classification of non-Hodgkin's lymphoma.
Between 1980 and 1982, 162 patients with non-Hodgkin's lymphoma were treated with cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) or CHOP plus bleomycin. At the moment when the patient were diagnosed all clinical characteristics were evaluated according to a multiple regression analysis model, which has the following three factors associated to bad prognosis: a quick clinical evolution (less than three months) bone marrow infiltration and high levels of lactate dehydrogenase (LDH). The Cox model of analysis also agreed that a quick clinical evolution and the high levels of LDH were bad prognosis factors. These two factors were associated with poor complete remission and short survival rates. A mathematical model was built based on the last two factors. Five groups of patients were observed with increasing risk of a poor response and a short survival rates, which allowed us to identified three prognostic groups with clear differences in both the duration of remission and survival. These groups were low, moderate and high-risk. Results analysis in this paper have important clinical implications for the design of the prospective clinical trials in patients with malignant lymphoma.
Departamento de Hematología, Hospital de Oncología, Centro Médico Nacional, IMSS México, D.F.
A
A
Avilés
J C
JC
Díaz-Maqueo
L
L
Rodríguez
E L
EL
García
V
V
Torras
R
R
Guzmán
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D001761:Bleomycin / Q000008:administration & dosage; D001853:Bone Marrow / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008228:Lymphoma, Non-Hodgkin / Q000145:classification* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D008800:Mexico / Q000453:epidemiology; D009363:Neoplasm Proteins / Q000097:blood; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D012044:Regression Analysis; D012307:Risk Factors; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D011241:Prednisone