Utility in prognostic value added by molecular profiles for diffuse large B-cell lymphoma.

摘要

We read with interest the report from Hong et al1 on the incremental prognostic value of gene expression signatures in diffuse large B-cell lymphoma (DLBCL). We were surprised by the conclusions that these "signatures are inferior to clinical factors and provide little added value in risk assessment" when considering a 2-gene score (TGS) and a 6-gene score described by us2"4 and others.5 The authors' claim that "all studies assess predictive significance based on P value from multivariable Cox regression" was also surprising, because dedicated parts of prior studies specifically addressed added prognostic value. We reported robust risk reclassification by integration of molecular indices (TGS) with clinical factors within the international prognostic index (IPI) (TGS-IPI),2 and both our study and the study of Lenz et al5 demonstrated splitting of IPI strata using molecular signatures.