{"id":299,"date":"2010-05-12T23:56:44","date_gmt":"2010-05-12T21:56:44","guid":{"rendered":"http:\/\/www.pjh.fr\/wordpress\/?p=299"},"modified":"2011-10-19T01:42:52","modified_gmt":"2011-10-18T23:42:52","slug":"ipi-is-not-not-dead","status":"publish","type":"post","link":"http:\/\/www.pjh.fr\/wordpress\/?p=299","title":{"rendered":"IPI is not not dead"},"content":{"rendered":"

Ipi, ipi… Hourra ! (ok j’ai honte du jeu de mot)<\/p>\n

On est sauv\u00e9, on a eu chaud… Un score simple \u00e0 calculer qui tient \u00e0 l’heure des th\u00e9rapies cibl\u00e9es, notre vieil index pronostic pour les lymphomes B agressifs\u00a0 (IPI) publi\u00e9 en 1993 dans le NEJM tient le coup, c’est le JCO qui le dit…<\/p>\n

Journal of Clinical Oncology<\/em>, Vol 28, No 14 (May 10), 2010: pp. 2373-2380
\n<\/span>Standard International Prognostic Index Remains a Valid Predictor of Outcome for Patients With Aggressive CD20+<\/sup> B-Cell Lymphoma in the Rituximab Era
\nMarita Ziepert, Dirk Hasenclever, Evelyn Kuhnt, Bertram Glass, Norbert Schmitz, Michael Pfreundschuh, Markus Loeffler<\/strong><\/p><\/blockquote>\n

On ne change rien : 5 facteurs<\/strong> (\u00e2ge ? ou > 60 ans ; LDH, PS 0 ou vs > 1 ; stade d’Ann Arbor I\/II vs III\/IV et nombre d’atteintes extra-ganglionnaires 0-1 vs > 1) ou la version \u00ab\u00a0aa\u00a0\u00bb (rien \u00e0 voir avec le groupe de musique des ann\u00e9es 80) pour \u00ab\u00a0age adjusted\u00a0\u00bb chez les patients jeunes qui ne comprend que 3 facteurs (LDH, PS et stade).<\/p>\n

En 1993, les patients avaient re\u00e7u un traitement de type CHOP ou apparent\u00e9 (CHOP-like en bon fran\u00e7ais), l’IPI restait-il d’actualit\u00e9 aujourd’hui pour des patients trait\u00e9s par CHOP + Ritixumab (R-CHOP pour les intimes). Shen et al avaient publi\u00e9 un R-IPI (Revisited-IPI) mais manifestement les auteurs de l’article du JCO trouvaient leur m\u00e9thode statistique pas tr\u00e8s bonne (c’est vrai, Shen et al avaient publi\u00e9 dans une petite revue, la gazette h\u00e9matologique am\u00e9ricaine : blood, sans faire de multivari\u00e9, les m\u00e9cr\u00e9ants…)… Bref, nos voisins et n\u00e9anmoins amis Allemands ont repris \u00e7a de mani\u00e8re plus s\u00e9rieuse (selon eux) et ont \u00e9valu\u00e9 1062 patients trait\u00e9s par R-CHO(E)P…<\/p>\n

Wunderbar ! L’IPI et la version aaIPI fonctionnent toujours… Et pas que pour la survie globale mais \u00e9galement l’EFS et la PFS… Unm\u00f6glich, non ? \ud83d\ude06<\/p>\n\n\n\n
\n\n\n\n\n\n\n\n\n\n\n
Variable<\/td>\nPatients<\/p>\n
<\/td>\n		EFS<\/p>\n
<\/td>\n		PFS<\/p>\n
<\/td>\n		OS<\/p>\n
<\/td>\n<\/tr>\n
No.<\/td>\n%<\/td>\n3-Year Rate<\/td>\n95% CI<\/td>\n3-Year Rate<\/td>\n95% CI<\/td>\n3-Year Rate<\/td>\n95% CI<\/td>\n<\/tr>\n
All trials (IPI score)<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
0, 1<\/td>\n553<\/td>\n52<\/td>\n81.3<\/td>\n77.8 to 84.8<\/td>\n87.0<\/td>\n83.9 to 90.1<\/td>\n91.4<\/td>\n88.9 to 93.9<\/td>\n<\/tr>\n
2<\/td>\n227<\/td>\n21<\/td>\n68.5<\/td>\n62.0 to 75.0<\/td>\n74.7<\/td>\n68.6 to 80.8<\/td>\n80.9<\/td>\n75.4 to 86.4<\/td>\n<\/tr>\n
3<\/td>\n175<\/td>\n17<\/td>\n53.2<\/td>\n45.4 to 61.0<\/td>\n58.6<\/td>\n50.8 to 66.4<\/td>\n65.1<\/td>\n57.7 to 72.6<\/td>\n<\/tr>\n
4, 5<\/td>\n105<\/td>\n10<\/td>\n49.5<\/td>\n39.5 to 59.5<\/td>\n55.8<\/td>\n45.8 to 65.8<\/td>\n59.0<\/td>\n49.2 to 68.8<\/td>\n<\/tr>\n
Total<\/td>\n1,062<\/td>\n100<\/td>\n70.5<\/td>\n67.6 to 73.4<\/td>\n76.4<\/td>\n73.7 to 79.1<\/td>\n81.5<\/td>\n79.0 to 84.0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\"\"<\/a><\/p>\n\n

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Ipi, ipi… Hourra ! (ok j’ai honte du jeu de mot) On est sauv\u00e9, on a eu chaud… Un score simple \u00e0 calculer qui tient \u00e0 l’heure des th\u00e9rapies cibl\u00e9es, notre vieil index pronostic pour les lymphomes B agressifs\u00a0 (IPI) publi\u00e9 en 1993 dans le NEJM tient le coup, c’est le JCO qui le dit… […]<\/p>\n","protected":false},"author":1,"featured_media":310,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[87],"tags":[31,30,11],"_links":{"self":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/299"}],"collection":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=299"}],"version-history":[{"count":12,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/299\/revisions"}],"predecessor-version":[{"id":794,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/299\/revisions\/794"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/media\/310"}],"wp:attachment":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=299"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=299"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=299"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}