Application of an adapted international prognostic index for aggressive non-Hodgkin's lymphomas: Good discrimination and lower survival rates in Rio de Janeiro, Brazil

Institutions that treat patients with lymphoma must know their local therap y results and adapt their treatment strategies accordingly. To allow the ap plication of the International Prognostic Factor Index (IPI) in institution s where some of the data necessary are not available, we devised an approac h by which the missing data would not impair the applicability of the index . We also collapsed the four categories of the IPI into two categories, and applied this adapted IPI to patients with aggressive non-Hodgkin's lymphom a treated in a public university hospital. Among the 72 patients treated wi th combination chemotherapy regimens containing doxorubicin, the following outcomes were observed for low and high risk groups, respectively: complete remission rates were 62% and 45% (p=0.2), overall survival rates were 48% and 14% (p=0.0098) and failure-free survival rates were 44% and 17% (p=0.03 ). This adapted IPI was very effective in predicting the outcome in the pat ients studied. The survival rates observed in our population were substanti ally lower than the rates reported in the IPI study. Patient selection migh t have played an important role in this difference, although other factors related to the social acid general health status of the patients treated ne ed to be prospectively studied.