{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T21:41:12Z","timestamp":1715982072053},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T00:00:00Z","timestamp":1583712000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T00:00:00Z","timestamp":1583712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Composite follicular lymphoma with diffuse large B-cell lymphoma (FL\/DLBCL) is uncommonly found on lymph node biopsy and represents a rare haematological malignancy. We aim to examine clinico-pathological features of patients with FL\/DLBCL and investigate predictors of survival outcome. We included in our retrospective study patients with histologically-proven FL\/DLBCL at diagnosis (n\u2009=\u2009106) and who were subsequently treated with rituximab-based chemoimmunotherapy from 2002\u20132017 at the National Cancer Centre. The cohort consisted of 34 women and 72 men with a median age of 59 years (range, 24\u201382). In a multivariate model inclusive of known clinico-pathological parameters at diagnosis, advanced stage (<jats:italic>p<\/jats:italic>\u2009=\u20090.0136), presence of <jats:italic>MYC<\/jats:italic> and\/or <jats:italic>BCL6<\/jats:italic> rearrangement (<jats:italic>p<\/jats:italic>\u2009=\u20090.0376) and presence of B symptoms (<jats:italic>p<\/jats:italic>\u2009=\u20090.0405) were independently prognostic for worse overall survival (OS). The only remaining independent prognostic variables for worse OS after including first-line treatment data in the model were use of chemotherapy regimens other than R-CHOP (<jats:italic>p<\/jats:italic>\u2009=\u20090.0360) and lack of complete response to chemotherapy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) besides the presence of B symptoms (<jats:italic>p<\/jats:italic>\u2009=\u20090.0022). We generated a Clinico-Genotypic Index by point-wise addition of all five adverse parameters (score of 0\u20131, 2, 3, 4\u20135) which revealed four prognostic risk groups with a predicted 5-year OS of 100%, 62%, 40% and 0% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) accounting for 50.0%, 24.5%, 18.9% and 6.6% of the cohort respectively. We propose that R-CHOP should be the recommended first-line regimen for composite FL\/DLBCL.<\/jats:p>","DOI":"10.1038\/s41598-020-61378-4","type":"journal-article","created":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T11:02:46Z","timestamp":1583751766000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A Clinico-Genotypic Prognostic Index for De Novo Composite Diffuse Large B-Cell Lymphoma Arising from Follicular Lymphoma in Asian patients treated in the Rituximab Era"],"prefix":"10.1038","volume":"10","author":[{"given":"Ryan Mao Heng","family":"Lim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie Pei Xin","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lay Poh","family":"Khoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chee Leong","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen Yi Ling","family":"Poon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagavalli","family":"Somasundaram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Farid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany Pooi Ling","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soon Thye","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason Yongsheng","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"key":"61378_CR1","doi-asserted-by":"publisher","first-page":"3909","DOI":"10.1182\/blood.V89.11.3909","volume":"89","author":"A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin\u2019s lymphoma","year":"1997","unstructured":"A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin\u2019s lymphoma. 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