JLE

Hématologie

MENU

Prognostic factors in diffuse large B-cell lymphoma at diagnosis (international prognostic index excluded) Volume 27, supplement 1, Mars 2021

Figures


  • Figure 1

  • Figure 2

Tables

Authors
1 Service d’anatomie pathologique, hôpital Saint-Louis, AP-HP, Paris, France; Université de Paris, Paris Diderot, Paris, France
2 Service de médecine nucléaire, hôpital Saint-Louis, AP-HP, Paris, France
3 Service d’hémato-oncologie, hôpital Saint-Louis, AP-HP, Paris, France
4 Université de Paris, Paris Diderot, Paris, France
* Tirés à part

Diffuse large B cell lymphoma (DLBCL) is the most common adult non-Hodgkin lymphoma, accounting for 30 % to 40 % of all lymphomas. The prognosis is heterogeneous, depending on various factors related to the patient (in particular age and performance status) or to the characteristics of the lymphoma. Initially based on the Ann-Arbor staging developed in 1971, the prognostic stratification was later enriched with the international prognostic index (IPI) developed in 1993, and revised in 2007 after the introduction of rituximab (R-IPI). Since then, a large number of prognostic factors have been identified, based on morphological (immunoblastic aspect or not), immunohistochemical (cell of origin, overexpression of MYC and/or BCL2 proteins, expression of the TP53 protein, expression of CD30, CD5, PD-1 and/or PD-L1, proliferation index), and molecular (rearrangement of MYC/BCL2/BCL6 genes and mutational profile) characteristics of DLBCLs, and more recently from functional imaging (total metabolic tumor volume) or circulating tumor DNA. All these elements can be taken into consideration when deciding on patient care during multidisciplinary consultation meetings, although R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) still remains in 2021 the reference treatment of DLBCL.