B Cell Lymphoma Survival Rate: Method To Determine Prognosis For Diffuse Large B Cell Lymphoma

B cell lymphoma is not one disease but a few dozen heterogeneous diseases, or individual cancers, that affect the b-cells in the lymphatic system. However, the most common type of b cell lymphoma is diffuse large b-cell lymphoma (DLBCL), and researchers have come up with a rather handy method of determining prognosis for people with DLBCL. The method is known by its initials, the R-IPI, which stands for the Revised International Prognostic Index.

The R-IPI works by identifying a specific patient group—those who have been diagnosed with DLBCL and who are then treated with the R-CHOP chemotherapeutic regimen.

The R-IPI asks five questions, and assigns a point per question when called for.

  1. Is the patient younger or older than 60? If younger, 0 points. If 60 or older, 1 point.
  2. What is the patient's ECOG performance status score? [see * below]. If 0-2, 0 points. If 3-4, 1 point.
  3. Is the patient's LDH normal or elevated? If normal, 0 points. If elevated, 1 point.
  4. How many extranodal sites are involved? If no more than 1, 0 points. If 2 or more, 1 point.
  5. What stage disease? If the patient's cancer is stage I or II, 0 points. If III or IV, 1 point.

The R-IPI then identifies three prognostic groups according to points.

  • 0 points: Prognosis, Very good (4-year progression-free survival 94%, overall survival, 94%)
  • 1-2 points: Prognosis, Good (4-year PFS 80%, OS 79%)
  • 3-5 points: Prognosis, Poor (4-year PFS 53%, OS 55%)

The R-IPI doesn't recognize risk groups with a perceived B cell lymphoma survival rate of under 50%.

Researchers are always looking for new methods to determine survival rates, especially among b cell lymphomas, because they are so common, but readers should be aware of the limitations of these indices since each person is different and each person's cancer is also different.

*ECOG status: This is a scale to determine how a disease affects a patient's daily life. To see what each score means, refer to this explanation offered by the National Cancer Institute.

Source: Sehn LH et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP Blood

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