Identifier to cite or link to this item: https://hdl.handle.net/20.500.13003/19331
Evaluation of 4 prognostic indices in follicular lymphoma treated in first line with immunochemotherapy
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AuthorRodríguez-Sevilla, Juan Jose; Fernández-Rodríguez, Concepción; Bento, Leyre ; Diez-Feijóo, Ramón; Pinzón, Sergio; Gibert, Joan; Fernández-Ibarrondo, Lierni; Lafuente, Marta; Ferrer, Ana; Sánchez-González, Blanca; Gimeno, Eva; Sainz, Juan; Ramos, Rafael; García, Juan F; Colomo, Lluis; Bellosillo, Beatriz; Gutierrez, Antonio ; Salar, Antonio
Document typeresearch article
CitationRodríguez-Sevilla JJ, Fernández-Rodríguez C, Bento L, Diez-Feijóo R, Pinzón S, Gibert J, et al. Evaluation of 4 prognostic indices in follicular lymphoma treated in first line with immunochemotherapy. Blood Adv. 2023 Apr 25;7(8):1606–14.
Several clinical risk models have been proposed to predict the outcome of follicular lymphoma (FL). The development of next-generation sequencing technologies has allowed the integration of somatic gene mutations into clinical scores to build genotyped-based risk models, such as the m7-Follicular Lymphoma International Prognostic Index (FLIPI). We explored 4 clinical or clinicogenetic-risk models in patients with symptomatic FL who received frontline immunochemotherapy. Of 191 patients with FL grades 1 to 3a, 109 were successfully genotyped. The treatment consisted of rituximab (R) plus cyclophosphamide, vincristine, and prednisone (R-CVP)/cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) (72.5%) or R-bendamustine (R-B) (27.5%). The proportion of cases classified as high risk for FLIPI, FLIPI-2, PRIMA-prognostic index, or m7-FLIPI were 39.3%, 14%, 30.3%, and 22%, respectively. No case with low-intermediate FLIPI was upgraded in the m7-FLIPI, but 18 of the 42 high-risk patients with FLIPI were downgraded to low-risk m7-FLIPI. The sensitivity and specificity for the prediction of POD24 were highest for FLIPI. The discrimination between progression-free survival (PFS) and overall survival (OS) was the best for FLIPI (c-index: 0.644 and 0.727, respectively). When analyzed only in patients treated with R-B, m7-FLIPI showed a higher discrimination between PFS and OS. Thus, the FLIPI remains the clinical risk score with higher discrimination in patients with advanced FL treated with immunochemotherapy; however, the performance of the m7-FLIPI should be further investigated in patients treated with R-B.