Comparison of prognostic models in diffuse large B cell lymphoma cases

NHL; is the most common hematological malignancy and the most common subtype is DLBCL. DLBCL; it accounts for 31% of all NHLs in western countries. The prevalence of DLBCL, which is more frequently observed in men, increases with age. Diagnosis is made by histopathological examination of excisional biopsy specimen. Although it is an advanced age disease, several prognostic models have been developed to be used in the management of DLBCL and treatment management with increasing treatment options. The first was IPI, which was created in 1993 and is the most commonly used. Subsequently, R-IPI was developed by incorporating rituximab into the treatment regimen. In 2014, NCCN-IPI was created. In the literature; There are limited comparison studies between prognostic models (IPI, R-IPI and NCCN-IPI). With this research; We aimed to compare three different prognostic models in terms of progression-free survival and overall survival. In our study, we included 167 patients with DLBCL and retrospectively reviewed the patient data. Patients' demographic data, date of diagnosis, laboratory values, prognosis scores calculated according to IPI, R-IPI and NCCN-IPI, disease stages, treatment and responses were recorded. The median follow-up was 17 months. According to IPI, 2-year progression-free survival was similar in the cohorts risk groups, while overall survival was longer in the validation cohort. The 4-year progression-free survival rate of the R-IPI risk groups was found to be higher in the good risk group of the original R-IPI cohort, whereas the rate of other risk groups was similar; overall survival was longer in the validation cohort. The 5-year progression-free survival was lower in the NCCN-IPI risk groups, except for the high-moderate risk group, while overall survival was longer in the validation cohort. In our study, the progression-free survival and overall survival values of the three prognostic models were similar, and the ability of IPI, R-IPI, and NCCN-IPI to distinguish between risk groups was similar. Prospective, randomized, multicenter comparison studies involving clinical, immunohistochemical, cytogenetic and molecular parameters are required for stronger risk classification. Key Words: IPI, R-IPI, NCCN-IPI