{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T16:35:51Z","timestamp":1794242151194,"version":"4.9.0"},"reference-count":25,"publisher":"American Society of Hematology","issue":"23","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Great heterogeneity in survival exists for patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL). Three scoring systems incorporating simple clinical parameters (age, lactate dehydrogenase, number\/sites of involvement, stage, performance status) are widely used: the International Prognostic Index (IPI), revised IPI (R-IPI), and National Comprehensive Cancer Network IPI (NCCN-IPI). We evaluated 2124 DLBCL patients treated from 1998 to 2009 with frontline rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP; or variant) across 7 multicenter randomized clinical trials to determine which scoring system best discriminates overall survival (OS). Median age was 63 years, and 56% of patients were male. Five-year OS estimates ranged from 54% to 88%, from 61% to 93%, and from 49% to 92% using the IPI, R-IPI, and NCCN-IPI, respectively. The NCCN-IPI had the greatest absolute difference in OS estimates between the highest- and lowest-risk groups and best discriminated OS (concordance index = 0.632 vs 0.626 [IPI] vs 0.590 [R-IPI]). For each given IPI risk category, NCCN-IPI risk categories were significantly associated with OS (P \u2264 .01); the reverse was not true, and the IPI did not provide additional significant prognostic information within all NCCN-IPI risk categories. Collectively, the NCCN-IPI outperformed the IPI and R-IPI. Patients with low-risk NCCN-IPI had favorable survival outcomes with little room for further improvement. In the rituximab era, none of the clinical risk scores identified a patient subgroup with long-term survival clearly &amp;lt;50%. Integrating molecular features of the tumor and microenvironment into the NCCN-IPI or IPI might better characterize a high-risk group for which novel treatment approaches are most needed.<\/jats:p>","DOI":"10.1182\/blood.2019002729","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T21:18:46Z","timestamp":1585689526000},"page":"2041-2048","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":323,"title":["International prognostic indices in diffuse large B-cell lymphoma: a comparison of IPI, R-IPI, and NCCN-IPI"],"prefix":"10.1182","volume":"135","author":[{"given":"Amy S.","family":"Ruppert","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, The Ohio State University, Columbus, OH;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse G.","family":"Dixon","sequence":"first","affiliation":[{"name":"Department of Health Science Research, Mayo Clinic, Rochester, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-8666","authenticated-orcid":false,"given":"Gilles","family":"Salles","sequence":"first","affiliation":[{"name":"Hematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, University of Lyon, Pierre-Benite, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Wall","sequence":"first","affiliation":[{"name":"Department of Health Science Research, Mayo Clinic, Rochester, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5158-1069","authenticated-orcid":false,"given":"David","family":"Cunningham","sequence":"first","affiliation":[{"name":"Department of Medicine, Royal Marsden Hospital, Surrey, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"Poeschel","sequence":"first","affiliation":[{"name":"Innere Medizin I, Universit\u00e4t des Saarlandes, Homburg, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Haioun","sequence":"first","affiliation":[{"name":"Unite Hemopathies Lymphoides, Hopital Henri Mondor, Creteil, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herve","family":"Tilly","sequence":"first","affiliation":[{"name":"Centre Henri-Becquerel, Universit\u00e9 de Rouen, Rouen, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herve","family":"Ghesquieres","sequence":"first","affiliation":[{"name":"Hematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, University of Lyon, Pierre-Benite, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marita","family":"Ziepert","sequence":"first","affiliation":[{"name":"Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, 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