Optimal Use of Prognostic Factors in Non-Hodgkin Lymphoma
Open Access
- 1 January 2006
- journal article
- review article
- Published by American Society of Hematology in Hematology-American Society Hematology Education Program
- Vol. 2006 (1), 295-302
- https://doi.org/10.1182/asheducation-2006.1.295
Abstract
The management of non-Hodgkin lymphoma is complicated by wide heterogeneity within recognized subtypes. Patients with supposedly similar diagnoses can have remarkably varied clinical presentations, molecular profiles and clinical outcomes. Reliable prognostic markers could allow the identification of patient subsets that may benefit from alternate approaches. Historically, a large number of clinical and molecular prognostic factors have been elucidated. However, the recent introduction of new therapies such as monoclonal antibodies has revolutionized treatment practices and greatly improved outcomes. This has called into question the value of previously recognized prognostic factors that need to be revalidated in the era of immunochemotherapy. It would appear that the commonly used clinical indices (IPI and FLIPI) retain predictive capacity, although they may have limited ability to identify a very poor outcome group. Currently there are no molecular markers that have been revalidated and shown to retain significance in the setting of current treatment practices for diffuse large B-cell lymphoma or follicular lymphoma. The biologic insights provided by molecular studies should allow for more targeted therapies to be developed, which will increase treatment choice and the possibility of tailored therapy in the future. It is imperative that future steps forward be made in the context of well-designed clinical trials with prospective correlative studies of clinical and biologic markers. This will allow us to continuously assess outcome predictors in the context of treatment change and to rationally design tailored treatment algorithms.Keywords
This publication has 48 references indexed in Scilit:
- Rituximab-CHOP Versus CHOP Alone or With Maintenance Rituximab in Older Patients With Diffuse Large B-Cell LymphomaJournal of Clinical Oncology, 2006
- CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) GroupThe Lancet Oncology, 2006
- Prognostic Biomarkers in Diffuse Large B-Cell LymphomaJournal of Clinical Oncology, 2006
- Revised International Prognostic Index (R-IPI) Is a Better Predictor of Outcome Than the Standard IPI for Patients with Diffuse Large B-Cell Lymphoma (DLBCL) Treated with Rituximab and CHOP (R-CHOP).Blood, 2005
- Six, Not Eight Cycles of Bi-Weekly CHOP with Rituximab (R-CHOP-14) Is the Preferred Treatment for Elderly Patients with Diffuse Large B-Cell Lymphoma (DLBCL): Results of the RICOVER-60 Trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL).Blood, 2005
- Advances in the biology and therapy of diffuse large B-cell lymphoma: moving toward a molecularly targeted approachBlood, 2005
- Introduction of Combined CHOP Plus Rituximab Therapy Dramatically Improved Outcome of Diffuse Large B-Cell Lymphoma in British ColumbiaJournal of Clinical Oncology, 2005
- Long-Term Results of the R-CHOP Study in the Treatment of Elderly Patients With Diffuse Large B-Cell Lymphoma: A Study by the Groupe d'Etude des Lymphomes de l'AdulteJournal of Clinical Oncology, 2005
- Emerging prognostic factors in diffuse large B cell lymphomaCurrent Opinion in Oncology, 2004
- A Predictive Model for Aggressive Non-Hodgkin's LymphomaNew England Journal of Medicine, 1993