Evaluation of 4 prognostic indices in follicular lymphoma treated in first line with immunochemotherapy
Metadatos
Afficher la notice complèteEditorial
American Society of Hematology
Date
2023-04-26Referencia bibliográfica
Rodríguez-Sevilla, J. J., Fernández-Rodríguez, C., Bento, L., Diez-Feijóo, R., Pinzón, S., Gibert, J., ... & Salar, A. (2023). Evaluation of 4 prognostic indices in follicular lymphoma treated in first line with immunochemotherapy. Blood Advances, 7(8), 1606-1614[https://doi.org/10.1182/bloodadvances.2022007949]
Patrocinador
Instituto de Salud Carlos III (ISCIII; European Union (FIS-FEDER PI15/0459, FIS-FEDER PI19/00034; GILEAD GLD18/00117, 2017SGR205, and PT20/00023); Xarxa de Banc de Tumors de Catalunya; Pla Director d’Oncologia de Catalunya; The biobank of the FundaciónRésumé
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.