%0 Journal Article %1 Ziepert.2010 %A Ziepert, Marita %A Hasenclever, Dirk %A Kuhnt, Evelyn %A Glass, Bertram %A Schmitz, Norbert %A Pfreundschuh, Michael %A Loeffler, Markus %D 2010 %J Journal of clinical oncology : official journal of the American Society of Clinical Oncology %K Adolescent Adult Aged Aged,_80_and_over Antibodies,_Monoclonal/administration_&_dosage Antibodies,_Monoclonal,_Murine-Derived Antigens,_CD20/immunology Antineoplastic_Combined_Chemotherapy_Protocols/administration_&_dosage Computer_Simulation Cyclophosphamide/administration_&_dosage Disease_Progression Disease-Free_Survival Doxorubicin/administration_&_dosage Female Health_Status_Indicators Humans Kaplan-Meier_Estimate Lymphoma,_B-Cell/diagnosis/drug_therapy/immunology/mortality Male Middle_Aged Predictive_Value_of_Tests Prednisone/administration_&_dosage Proportional_Hazards_Models Prospective_Studies Risk_Assessment Risk_Factors Time_Factors Treatment_Outcome Vincristine/administration_&_dosage Young_Adult %N 14 %P 2373–2380 %T Standard International prognostic index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era %V 28 %X PURPOSE\r\nThe International Prognostic Index (IPI) is widely used for risk stratification of patients with aggressive B-cell lymphoma. The introduction of rituximab has markedly improved outcome, and R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine, prednisone) has become the standard treatment for CD20(+) diffuse large B-cell lymphoma. To investigate whether the IPI has maintained its power for risk stratification when rituximab is combined with CHOP, we analyzed the prognostic relevance of IPI in three prospective clinical trials.\r\nPATIENTS AND METHODS\r\nIn total, 1,062 patients treated with rituximab were included (MabThera International Trial MInT, 380 patients; dose-escalated regimen of cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (MegaCHOEP) trial, 72 patients; CHOP + rituximab for patients older than age 60 years RICOVER-60 trial, 610 patients). A multivariate proportional hazards modeling was performed for single IPI factors under rituximab on event-free, progression-free, and overall survival.\r\nRESULTS\r\nIPI score was significant for all three end points. Rituximab significantly improved treatment outcome within each IPI group resulting in a quenching of the Kaplan-Meier estimators. However, IPI was a significant prognostic factor in all three end points and the ordering of the IPI groups remained valid. The relative risk estimates of single IPI factors and their order in patients treated with R-CHOP were similar to those found with CHOP.\r\nCONCLUSION\r\nThe effects of rituximab were superimposed on the effects of CHOP with no interactions between chemotherapy and antibody therapy. These results demonstrate that the IPI is still valid in the R-CHOP era.

@article{Ziepert.2010, abstract = {PURPOSE\r\nThe International Prognostic Index (IPI) is widely used for risk stratification of patients with aggressive B-cell lymphoma. The introduction of rituximab has markedly improved outcome, and R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine, prednisone) has become the standard treatment for CD20(+) diffuse large B-cell lymphoma. To investigate whether the IPI has maintained its power for risk stratification when rituximab is combined with CHOP, we analyzed the prognostic relevance of IPI in three prospective clinical trials.\r\nPATIENTS AND METHODS\r\nIn total, 1,062 patients treated with rituximab were included (MabThera International Trial [MInT], 380 patients; dose-escalated regimen of cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (MegaCHOEP) trial, 72 patients; CHOP + rituximab for patients older than age 60 years [RICOVER-60] trial, 610 patients). A multivariate proportional hazards modeling was performed for single IPI factors under rituximab on event-free, progression-free, and overall survival.\r\nRESULTS\r\nIPI score was significant for all three end points. Rituximab significantly improved treatment outcome within each IPI group resulting in a quenching of the Kaplan-Meier estimators. However, IPI was a significant prognostic factor in all three end points and the ordering of the IPI groups remained valid. The relative risk estimates of single IPI factors and their order in patients treated with R-CHOP were similar to those found with CHOP.\r\nCONCLUSION\r\nThe effects of rituximab were superimposed on the effects of CHOP with no interactions between chemotherapy and antibody therapy. These results demonstrate that the IPI is still valid in the R-CHOP era.}, added-at = {2014-10-14T15:28:15.000+0200}, author = {Ziepert, Marita and Hasenclever, Dirk and Kuhnt, Evelyn and Glass, Bertram and Schmitz, Norbert and Pfreundschuh, Michael and Loeffler, Markus}, biburl = {https://www.bibsonomy.org/bibtex/289ac1171d936765246b1600ccbfc1d99/drtester}, interhash = {d75c14ccabd64a40ecc18918ef82b379}, intrahash = {89ac1171d936765246b1600ccbfc1d99}, journal = {Journal of clinical oncology : official journal of the American Society of Clinical Oncology}, keywords = {Adolescent Adult Aged Aged,_80_and_over Antibodies,_Monoclonal/administration_&_dosage Antibodies,_Monoclonal,_Murine-Derived Antigens,_CD20/immunology Antineoplastic_Combined_Chemotherapy_Protocols/administration_&_dosage Computer_Simulation Cyclophosphamide/administration_&_dosage Disease_Progression Disease-Free_Survival Doxorubicin/administration_&_dosage Female Health_Status_Indicators Humans Kaplan-Meier_Estimate Lymphoma,_B-Cell/diagnosis/drug_therapy/immunology/mortality Male Middle_Aged Predictive_Value_of_Tests Prednisone/administration_&_dosage Proportional_Hazards_Models Prospective_Studies Risk_Assessment Risk_Factors Time_Factors Treatment_Outcome Vincristine/administration_&_dosage Young_Adult}, number = 14, pages = {2373–2380}, timestamp = {2014-10-14T15:28:15.000+0200}, title = {Standard International prognostic index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era}, volume = 28, year = 2010 }