title: The modified International Prognostic Index can predict the outcome of localized primary intestinal lymphoma of both extranodal marginal zone B-cell and diffuse large B-cell histologies.
abstract: We have previously reported on the efficacy of a modified International Prognostic Index (MIPI) in predicting the outcome of patients with primary gastric lymphoma. This prompted the retrospective analysis of a large series of patients with primary intestinal lymphoma (PIL) of both diffuse large B-cell (DLCL) and low-grade (extranodal marginal zone B-cell lymphoma, MZL) histology. Clinical records of 122 patients with localized primary intestinal lymphoma of MZL (n=35) and DLCL (n=87) histology, confirmed by an ad hoc expert panel of pathologists, were reviewed. Forty-nine patients were treated with single therapy, while 72 received combined-modality treatment, which included surgery followed by a short-term chemotherapy. MIPI was included in a multivariate prognostic analysis for overall survival (OS) and event-free survival (EFS). Sixty-five patients (75%) with DLCL and 22 with MZL(65%) achieved complete remission. After a median follow-up of 42 months (range 6-163 months), 5-year estimates of OS and EFS were 68% and 50% for DLCL and 65% and 26% for MZL. OS varied according to MIPI, from, respectively, 86% and 87% for DLCL and MZL patients with 0-1 risk factor to 50% and 32% for patients with > 1 risk factor (P=0.01 and P=0.02). Similar results were obtained for EFS. Cox regression analysis showed an unfavourable MIPI to be the only independent predictor of shorter EFS. This retrospective study shows that stage-MIPI can be a reliable prognostic indicator for PIL of both low-grade MZL and diffuse large B-cell histology, enabling the early identification of patients at higher risk of failure.
authors.affiliation: Divisione di Ematologia e Servizio di Anatomia Patologica e Citologia, Ospedali Riuniti di Bergamo, Bergamo, Italy. tbarbui@ospedaliruniti.bergamo.it
authors.forename: Sergio
authors.initials: S
authors.lastname: Cortelazzo
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Elena
authors.initials: E
authors.lastname: Oldani
authors.forename: Teresio
authors.initials: T
authors.lastname: Motta
authors.forename: Roberto
authors.initials: R
authors.lastname: Giardini
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
authors.forename: Emanuele
authors.initials: E
authors.lastname: Zucca
authors.forename: Henry
authors.initials: H
authors.lastname: Gomez
authors.forename: Andrés J M
authors.initials: AJ
authors.lastname: Ferreri
authors.forename: Graziella
authors.initials: G
authors.lastname: Pinotti
authors.forename: Claudio
authors.initials: C
authors.lastname: Chini
authors.forename: Liliana
authors.initials: L
authors.lastname: Devizzi
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Gianni
authors.forename: Franco
authors.initials: F
authors.lastname: Cavalli
authors.forename: Tiziano
authors.initials: T
authors.lastname: Barbui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000401:mortality / Q000628:therapy*; D016393:Lymphoma, B-Cell / Q000401:mortality / Q000628:therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate