Aggressive B-Cell Non-Hodgkin Lymphoma
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Gemlyn George, MBBS
Fellow, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Timothy S. Fenske, MD
Associate Professor of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Question 1 of 5

A 65-year-old man presents with abdominal pain that has been increasing over the past 3 months. He is less active than before but is able to mow the lawn and tend to his garden. Positron emission tomography (PET)/computed tomography (CT) scan shows adenopathy in the cervical and axillary regions as well as an 8-cm mass in the retroperitoneum. Excisional lymph node biopsy demonstrates diffuse large B-cell lymphoma (DLBCL). His complete blood count (CBC) is within normal limits. His lactate dehydrogenase (LDH) ratio is slightly elevated, but less than two-fold the upper limit of normal. Bone marrow biopsy shows no evidence of lymphoma. His National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) score is 4 (high/intermediate risk), which predicts a 56% survival at 5 years.

Which of the following factors contributes most to this patient's NCCN-IPI score?

Extranodal disease

LDH ratio

Patient’s age

Performance status

Hospital Physician: Hematology/Oncology. 2018 May;13(3)

This quiz is not accredited for CME.

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