Predicting outcomes in follicular lymphoma

This study examined the development of a prognostic score that could help in predicting patient outcome in follicular lymphoma (FL). This study determined that the FL International Prognostic Index they developed could be useful in choosing treatments and predicting outcome. 

Follicular lymphoma is an indolent form on non-Hodgkin lymphoma. While it may be less aggressive than other forms, FL has a tendency to relapse. Multiple treatments have been proposed and used in FL, but there is still a need to predict outcomes such as relapse.

The International Prognostic Index is useful for more aggressive forms of non-Hodgkin lymphoma, and it has been suggested that it could be useful in FL. However, a prognostic tool specifically for FL is needed.

The records of 4167 patients were included in this analysis. The average follow-up time was 7.5 years. Characteristics such as tumor stage, number of involved lymph nodes, levels of hemoglobin (a protein that is a measure of the number of red blood cells), and symptoms were examined.

Based on patient records, five factors were chosen for the FL International Prognostic Index (FLIPI). On factor was age (60 years or less versus over 60). The second factor was tumor stage (stage III or IV versus I or II). The third factor was hemoglobin level (less than 120 g/L versus more than 120 g/L). The fourth factor was number of involved lymph nodes (4 or less versus more than 4). The fifth factor was LDH level (normal versus above normal – an indication of cell or tissue damage in the body).

The FLIPI was tested on 919 of the patients, with an average follow-up of 6.8 years. Patients were labeled as low-risk (0-1 factors present), intermediate risk (2 factors), or poor risk (3 or more factors). The FLIPI was as (or even more so) predictive of patient outcome after 6.8 years than the IPI.

This study concluded that the FLIPI is a useful tool for choosing treatments and predicting patient outcome.