SIL index, comprising stage, soluble interleukin-2 receptor, and lactate dehydrogenase, is a useful prognostic predictor in diffuse large B-cell lymphoma.

Abstract

Rituximab (R) plus doxorubicin, cyclophosphamide, vincristine, and prednisolone (CHOP) chemotherapy (R-CHOP) is widely accepted as standard care for diffuse large B-cell lymphoma (DLBCL) patients. The revised International Prognostic Index (R-IPI) was established in 2007 after the addition of rituximab to standard DLBCL treatment. To reassess the utility of R-IPI, we carried out a retrospective analysis of patients with DLBCL uniformly treated with standard R-CHOP. Progression-free survival (PFS) curves in "very good" and "good" risk groups as defined by the R-IPI showed no statistical difference. We added soluble interleukin-2 receptor (sIL-2R) level to the factors comprising the R-IPI. Five levels of sIL-2R were weighed with respect to their impact on PFS. sIL-2R of >2500 U/mL was determined as the most appropriate threshold. We developed a new prognostic SIL index, which includes three independent prognostic risk factors: clinical stage (S); sIL-2R level over 2500 U/mL (I); and elevated lactate dehydrogenase level (L). This index indicates standard risk (0 or 1 risk factors, 4-year PFS 83%, 4-year overall survival 91%) and high risk (2 or 3 risk factors, 4-year PFS 52%, 4-year overall survival 67%) outcomes. The SIL index is a simple and objective prognostic index for DLBCL patients to identify candidates for experimental therapy other than R-CHOP.

• Authors: Naoto Tomita, Rika Sakai, Shin Fujisawa, Katsumichi Fujimaki, Jun Taguchi, Chizuko Hashimoto, Koji Ogawa, Etsuko Yamazaki, Yoshiaki Ishigatsubo
• Journal: Cancer science (Cancer Sci) Vol. 103 Issue 8 Pg. 1518-23 (Aug 2012) ISSN: 1349-7006 [Electronic] England
• PMID: 22587388 (Publication Type: Journal Article)
• Copyright: © 2012 Japanese Cancer Association.

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Biomarkers, Tumor
• R-CHOP protocol
• Receptors, Interleukin-2
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• L-Lactate Dehydrogenase
• Prednisone

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Murine-Derived (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers, Tumor (metabolism)
• Cyclophosphamide (therapeutic use)
• Disease-Free Survival
• Doxorubicin (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• L-Lactate Dehydrogenase (metabolism)
• Lymphoma, Large B-Cell, Diffuse (drug therapy, metabolism, mortality)
• Male
• Middle Aged
• Neoplasm Staging
• Prednisone (therapeutic use)
• Prognosis
• Receptors, Interleukin-2 (metabolism)
• Retrospective Studies
• Rituximab
• Survival Analysis
• Treatment Outcome
• Vincristine (therapeutic use)
• Young Adult