ISSN: 0034-8376
eISSN: 2564-8896

Central Nervous System International Prognostic Index Impacts Overall Survival in Diffuse Large B-cell Lymphoma Treated with R-Chop in a third Level Cancer Center from Mexico: A Survey of 642 Patients

Rubén Solís-Armenta, Department of Hematology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
Bernardo Cacho-Díaz, Department of Neuro-Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico
Olga Gutiérrez-Hernández, Pharmacogenetics Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
Myrna Candelaria-Hernández, Pharmacogenetics Laboratory; Hematology Department, Instituto Nacional de Cancerología, Mexico City, Mexico

Background: Central nervous system international prognosis index (CNS-IPI) is validated in European and the USA cancer databases. However, no validation has been done in Mexican population. Objective: The objective of the study was to assess the impact of the CNS-IPI on central nervous system (CNS) relapse and survival in Mexican patients with diffuse large B-cell lymphoma (DLBCL). Methods: In this retrospective analysis, clinical, biochemical, and histological variables and the CNS-IPI were analyzed. Results: Six hundred and forty-two patients with DBLCL were included in the study. The mean ± SD age was 56.8 ± 14.9 years. Most had an ECOG of 0-1: 75% (n = 484) had absence of B-symptoms and advanced disease (clinical stage: III-IV, n = 433, 67.4%). According to the CNS-IPI, almost one-half were in the low-risk category. According to the CNS-IPI, CNS relapse rate was 1.36% (95% CI: 83.2-92.8), 3.1% (95% CI: 132.4-162.8), and 7.4% (95% CI 61-91) for patients in the low-, intermediate-, and high-risk categories, respectively. The median overall survival in the high-risk group (CNS-IPI) was 22 months, and it has not been achieved after 80 months of follow-up for the other groups. Conclusions: CNS-IPI was associated with survival; therefore, we propose its use as a prognostic tool for prospective validation.

Keywords: Diffuse large B-cell lymphoma. Central nervous system relapse. Prognosis. Survival. Central Nervous System International Prognosis Index.