Evaluation of 4 prognostic indices in follicular lymphoma treated in first line with immunochemotherapy
| Autor: | Juan Jose Rodríguez-Sevilla, Concepción Fernández-Rodríguez, Leyre Bento, Ramón Diez-Feijóo, Sergio Pinzón, Joan Gibert, Lierni Fernández-Ibarrondo, Marta Lafuente, Ana Ferrer, Blanca Sánchez-González, Eva Gimeno, Juan Sainz, Rafael Ramos, Juan F. García, Lluis Colomo, Beatriz Bellosillo, Antonio Gutiérrez, Antonio Salar |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Blood Advances. 7:1606-1614 |
| ISSN: | 2473-9537 2473-9529 |
| DOI: | 10.1182/bloodadvances.2022007949 |
| Popis: | 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. 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 Fundación |
| Databáze: | OpenAIRE |
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