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CLIPI: a new prognostic index for indolent cutaneous B cell lymphoma proposed by the International Extranodal Lymphoma Study Group (IELSG 11)
B cell CLIPI Cutaneous Lymphoma Prognostic index
Indolent primary cutaneous B cell lymphomas (PCBCL) generally have a good prognosis, but they often relapse leading in some cases to extracutaneous disease and therefore, to poor survival. We developed a prognostic model to improve the therapeutic approach to these lymphomas. Two hundred and seventeen patients with diagnosis of indolent PCBCL stage IE or IIE were assessed retrospectively. The prognostic model was built to fit a Cox proportional hazard model using all the covariates affecting progression-free survival (PFS) at p < 0.1 in the univariate analysis, and the final model was selected based on the Bayes Information Criteria. Elevated serum lactate dehydrogenase, morphology of the lesion (nodule vs. other), and >2 lesions were independent predictors for PFS. To each prognostic factor was assigned a value of 1. Patients were then stratified to three risk groups: score 0 (28%), low risk; score 1 (55%), intermediate risk; score 2 and 3 (17%), high risk with a 5-year PFS of 91%, 64%, and 48%, respectively (p < 0.001). The CLIPI is an easily applicable prognostic index and represents a promising tool for risk-adapted treatment strategies. However, it needs to be addressed in prospective clinical studies.
Department of Hematology, Azienda Ospedaliera S. Maurizio, Hospital of Bolzano - Via Lorenz Böhler 5 - 39100 - Bolzano - ITALY (Mian, Michael) Laboratory of Experimental Oncology and Lymphoma Unit, Oncology Institute of Southern Switzerland (IOSI) - Bellinzona - SWITZERLAND (Mian, Michael) Department of Oncology and Hematology, University of Modena and Reggio Emilia - Modena - ITALY (Marcheselli, Luigi) Department of Oncology and Hematology, University of Modena and Reggio Emilia - Modena - ITALY (Luminari, Stefano) Department of Oncology and Hematology, University of Modena and Reggio Emilia - Modena - ITALY (Federico, Massimo) Università Tor Vergata - Rome - ITALY (Cantonetti, Maria) Department of Hematology, Hygeia Hospital and Harvard Medical International - Athens - GREECE (Sarris, Andreas H.) Division of Hematology, Ospedali Riuniti - Bergamo - ITALY (Rossi, Andrea) Division of Hematology, Ospedali Riuniti - Bergamo - ITALY (Rambaldi, Alessandro) III Division of Dermatology, Istituto Dermopatico dell’Immacolata, IRCCS - Rome - ITALY (Frontani, Marina) Medical Oncology 3 and Bone Marrow Transplantation Unit, Fondazione Istituto Nazionale per lo Studio e la Cura dei Tumori, University of Milan - Milan - ITALY (Devizzi, Liliana) Medical Oncology 3 and Bone Marrow Transplantation Unit, Fondazione Istituto Nazionale per lo Studio e la Cura dei Tumori, University of Milan - Milan - ITALY (Gianni, Alessandro Massimo) Department of Radiotherapy, Sezione Oncoematologica - Ospedale Umberto I - Mestre - ITALY (Busetto, Mario) University of Milan ‘Bicocca’ - Milan - ITALY (Berti, Emilio) Division of Haematology, European Institute of Oncology - Milan - ITALY (Martinelli, Giovanni) Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital - Toronto - CANADA (Tsang, Richard W.) Unit of Lymphoid Malignancies, San Raffaele Scientific Institute - Milan - ITALY (Ferreri, Andrés J. M.) Oncology - Varese - ITALY (Pinotti, Graziella) University of Milan ‘Bicocca’ - Milan - ITALY (Pogliani, Enrico) Oncology Institute of Southern Switzerland - Bellinzona - SWITZERLAND (Zucca, Emanuele) Department of Hematology, Azienda Ospedaliera S. Maurizio, Hospital of Bolzano - Via Lorenz Böhler 5 - 39100 - Bolzano - ITALY (Cortelazzo, Sergio)
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