The International Prognostic Index (IPI) is the most widely used score for non-Hodgkin lymphoma but lacks the ability to identify a high-risk population in diffuse large B-cell lymphoma (DLBCL). Low absolute lymphocyte count and high monocytes have proved to be unfavourable factors. Red-cell distribution width (RDW) has been associated with inflammation and beta-2 microglobulin (B2M) with tumour load. The retrospective study included 992 patients with DLBCL treated with R-CHOP. In the multivariate analysis, age, Eastern Cooperative Oncology Group performance status (ECOG-PS), stage, bulky mass, B2M, RDW, and lymphocyte/monocyte ratio (LMR) were independently related to progression-free survival (PFS). A new prognosis score was generated with these variables including age categorized into three groups (0, 1, 2 points); ECOG ≥ 3-4 with two; stage III/IV, bulky mass, high B2M, LMR < 2·25 and RDW > 0·96 with one each; for a maximum of 9. This score could improve the discrimination of a very high-risk subgroup with five-year PFS and overall survival (OS) of 19% and 24% versus 45% and 59% of R (revised)-IPI respectively. This score also showed greater predictive ability than IPI. A new score is presented including complete blood cell count variables and B2M, which are readily available in real-life practice without additional tests. Compared to R-IPI, it shows a more precise high-risk assessment and risk discrimination for both PFS and OS.

中文翻译：

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新的预后评分包括使用R-CHOP治疗的弥漫性大B细胞淋巴瘤患者的绝对淋巴细胞/单核细胞比例，红细胞分布宽度和β-2微球蛋白：西班牙淋巴瘤组经验（GELTAMO）。

国际预后指数（IPI）是非霍奇金淋巴瘤使用最广泛的评分，但缺乏鉴别弥漫性大B细胞淋巴瘤（DLBCL）高危人群的能力。低的绝对淋巴细胞计数和高的单核细胞已被证明是不利因素。红细胞分布宽度（RDW）与炎症相关，β-2微球蛋白（B2M）与肿瘤负荷相关。回顾性研究包括992例接受R-CHOP治疗的DLBCL患者。在多变量分析中，年龄，东部合作肿瘤小组的表现状态（ECOG-PS），阶段，肿块，B2M，RDW和淋巴细胞/单核细胞比率（LMR）与无进展生存期（PFS）独立相关。利用这些变量产生了新的预后评分，其中包括将年龄分为三组（0、1、2分）。ECOG≥3-4，两个；III / IV期，肿块，高B2M，LMR <2·25和RDW> 0·96，每一项；最高评分为9分。该评分可以改善对高危亚组的区分，该亚组的五年PFS和总生存（OS）分别为19％和24％，而R（修订）-IPI分别为45％和59％ 。该分数还显示出比IPI更高的预测能力。提出了一个新分数，其中包括完整的血细胞计数变量和B2M，可在现实生活中轻松获得，而无需进行额外的测试。与R-IPI相比，它显示了针对PFS和OS的更精确的高风险评估和风险区分。该分数可以改善高危亚组的五年PFS，总生存率（OS）分别为19％和24％，而R（修订）-IPI分别为45％和59％。该分数还显示出比IPI更高的预测能力。提出了一个新分数，其中包括完整的血细胞计数变量和B2M，可在现实生活中轻松获得，而无需进行额外的测试。与R-IPI相比，它显示了针对PFS和OS的更精确的高风险评估和风险区分。该评分可以改善具有五年PFS和19％和24％的总生存率（OS）的R（修订）-IPI分别为45％和59％的高危亚组的辨别力。该分数还显示出比IPI更高的预测能力。提出了一个新分数，其中包括完整的血细胞计数变量和B2M，可在现实生活中轻松获得，而无需进行额外的测试。与R-IPI相比，它显示了针对PFS和OS的更精确的高风险评估和风险区分。