CHOP-R therapy overcomes the adverse prognostic influence of BCL-2 expression in diffuse large B-cell lymphoma (DLBCL)
Bibliographic record
Abstract
6526 Background: Following the demonstration of superior survival with CHOP-R for pts >60 years with advanced DLBCL (GELA, ASH 2000, abst # 950), the BC Cancer Agency adopted CHOP-R for advanced DLBCL in March 2001. CHOP-R therapy is thought to negate the adverse effect of BCL-2 protein expression on response rates and survival (Mounier et al, Blood 2003). We report our experience to determine whether BCL-2 status remains a significant prognostic factor in advanced DLBCL for pts who receive CHOP-R. Methods: Eligibility: age >16 yrs; de novo DLBCL; HIV neg.; no CNS involvement; available BCL-2 protein expression. All pts had central histopathology review. BCL-2 tumor positivity was defined as 50%+ of tumor cells with BCL-2 protein expression. Treatment plan: for stage IA or IIA with bulk <10 cm, suitable for IFRT (limited stage), CHOP-R x 3 cycles + IFRT; for all other patients (advanced stage), CHOP-R for 6 –8 cycles depending on rate of response. High dose therapy (HDCT) with stem cell transplant was offered to suitable relapse/PD pts. who demonstrated response to multi-agent chemotherapy. Results: Between March 2001 and November 2003, 89 pts, median age 63 y (range 20–84) received CHOP-R; limited stage 3%, advanced 97%; IPI distribution: 0–1 (34%), 2–3 (45%), 4–5 ( 21%), elevated LDH (49%), bulky disease >10cm (27%). BCL-2 positive 55 (62%). IPI score was similar in both BCL-2 positive and negative sub-groups. Median follow-up time for living pts. is 16 months. Neither BCL-2 protein status nor IPI group was significantly predictive of PFS or OS (see table). Conclusions: The introduction of CHOP-R in British Columbia appears to negate the adverse effect of BCL-2 protein expression on survival in DLBCL and may decrease the impact of higher IPI score. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Roche Canada Roche Canada Roche Canada Roche Canada
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".