title: Application of an adapted international prognostic index for aggressive non-Hodgkin's lymphomas: good discrimination and lower survival rates in Rio de Janeiro, Brazil.
abstract: Institutions that treat patients with lymphoma must know their local therapy results and adapt their treatment strategies accordingly. To allow the application of the international prognostic factor index (IPI) in institutions where some of the data necessary are not available, we devised an approach by which the missing data would not impair the applicability of the index. We also collapsed the four categories of the IPI into two categories, and applied this adapted IPI to patients with aggressive non-Hodgkin's lymphoma treated in a public university hospital. Among the 72 patients treated with combination chemotherapy regimens containing doxorubicin, the following outcomes were observed for low and high risk groups, respectively: complete remission rates were 62% and 45% (p=0.2), overall survival rates were 48% and 14% (p=0.0098) and failure-free survival rates were 44% and 17% (p=0.03). This adapted IPI was very effective in predicting the outcome in the patients studied. The survival rates observed in our population were substantially lower than the rates reported in the IPI study. Patient selection might have played an important role in this difference, although other factors related to the social and general health status of the patients treated need to be prospectively studied.
authors.affiliation: Serviço de Hematologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Ilha do Fundao 21941-590, Brazil.
authors.forename: I
authors.initials: I
authors.lastname: Biasoli
authors.forename: J C
authors.initials: JC
authors.lastname: Morais
authors.forename: P
authors.initials: P
authors.lastname: Soares de Jesus
authors.forename: W
authors.initials: W
authors.lastname: Pulcheri
authors.forename: M
authors.initials: M
authors.lastname: Nucci
authors.forename: N
authors.initials: N
authors.lastname: Spector
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001853:Bone Marrow / Q000473:pathology; D001938:Brazil; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006779:Hospitals, Public; D006785:Hospitals, University; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013160:Splenic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D014505:Urban Population