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dc.contributor.authorHaynes, Andrew P.
dc.date.accessioned2018-03-06T14:17:24Z
dc.date.available2018-03-06T14:17:24Z
dc.date.issued2016-04
dc.identifier.citationBishton, M, Hughes, S, Richardson, F, James, E, Bessell, E, Sovani, V, Ganatra, R, Haynes, A, McMillan, A, & Fox, C 2016, 'Delineating outcomes of patients with diffuse large b cell lymphoma using the national comprehensive cancer network-international prognostic index and positron emission tomography-defined remission status; a population-based analysis', British Journal Of Haematology, 172, 2, p. 246.en
dc.identifier.urihttps://orda.derbyhospitals.nhs.uk/handle/123456789/1480
dc.description.abstractThe recently devised National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) appears superior to the revised IPI (R-IPI) in delineating outcome in diffuse large B-cell lymphoma. We examined the outcome of a population-based cohort of 223 consecutive patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) or R-CHOP-like immuno-chemotherapy between January 2005 and December 2011 by both the NCCN-IPI and R-IPI, and further stratified outcome by the achievement of both computerized tomography (CT) and positron emission tomography (PET)-CT complete remission (CR), with the latter reassessed using blinded central review by an independent nuclear medicine and radiology specialist. The NCCN-IPI was superior to the R-IPI in identifying patients at very high risk of systemic and/or central nervous system relapse. Notably, both the NCCN-IPI and the R-IPI remained strongly predictive of relapse irrespective of CT or PET-defined remission status following R-CHOP. Patients with high-risk NCCN-IPI scores (6) have a dismal outcome following R-CHOP therapy regardless of PET-defined response to R-CHOP. Moreover, such patients appear refractory to salvage chemotherapy and thus require alternative therapeutic approaches, although age and performance status may, for many patients, preclude the safe delivery of a primary intensified regimen. By contrast, patients with NCCN-IPI 1-5 who achieve PET-CR following R-CHOP have excellent outcomes and may merit reduced follow up frequency.en
dc.language.isoenen
dc.subjectNon-hodgkins-lymphomaen
dc.subjectLymphoma, Large B-Cellen
dc.subjectTomography, X-Ray Computeden
dc.subjectHaematologyen
dc.subjectChemotherapyen
dc.subjectPositron-Emission Tomographyen
dc.subjectNeoplasm Stagingen
dc.titleDelineating outcomes of patients with diffuse large b cell lymphoma using the national comprehensive cancer network-international prognostic index and positron emission tomography-defined remission status; a population-based analysis.en
dc.typeArticleen


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