Journal article
A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy
Blood, Vol.132(1), pp.49-58
07/05/2018
DOI: 10.1182/blood-2017-11-816405
PMCID: PMC6034646
PMID: 29666118
Abstract
In follicular lymphoma (FL), no prognostic index has been built based solely on a cohort of patients treated with initial immunochemotherapy. There is currently a need to define parsimonious clinical models for trial stratification and to add on biomolecular factors. Here, we confirmed the validity of both the follicular lymphoma international prognostic index (FLIPI) and the FLIPI2 in the large prospective PRIMA trial cohort of 1135 patients treated with initial R-chemotherapy ± R maintenance. Furthermore, we developed a new prognostic tool comprising only 2 simple parameters (bone marrow involvement and β
-microglobulin [β
m]) to predict progression-free survival (PFS). The final simplified score, called the PRIMA-PI (PRIMA-prognostic index), comprised 3 risk categories: high (β
m > 3 mg/L), low (β
m ≤ 3 mg/L without bone marrow involvement), and intermediate (β
m ≤ 3 mg/L with bone marrow involvement). Five-year PFS rates were 69%, 55%, and 37% in the low-, intermediate-, and high-risk groups, respectively (
< .0001). In addition, achieving event-free survival (EFS) or not at 24 months (EFS24) was a strong posttreatment prognostic parameter for subsequent overall survival, and the PRIMA-PI was correlated with EFS24. The results were confirmed in a pooled external validation cohort of 479 patients from the FL2000 LYSA trial and the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource. Five-year EFS in the validation cohort was 77%, 57%, and 44% in the PRIMA-PI low-, intermediate-, and high-risk groups, respectively (
< .0001). The PRIMA-PI is a novel and easy-to-compute prognostic index for patients initially treated with immunochemotherapy. This could serve as a basis for building more sophisticated and integrated biomolecular scores.
Details
- Title: Subtitle
- A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy
- Creators
- Emmanuel Bachy - Université Claude Bernard Lyon 1Matthew J Maurer - Mayo ClinicThomas M Habermann - Mayo ClinicBénédicte Gelas-Dore - The Lymphoma Academic Research OrganisationDelphine Maucort-Boulch - Laboratoire de Biométrie et Biologie EvolutiveJane A Estell - Concord Repatriation General HospitalEric Van den Neste - Cliniques Universitaires Saint-LucRéda Bouabdallah - Institut Paoli-CalmettesEmmanuel Gyan - Centre Hospitalier Universitaire de ToursAndrew L Feldman - Mayo ClinicJoan Bargay - Hospital Son LlatzerAlain Delmer - Université de Reims Champagne-ArdenneSusan L Slager - Mayo Clinic in FloridaMaria Gomes da Silva - Portuguese Institute of Oncology, Lisbon, PortugalOlivier Fitoussi - Polyclinique Bordeaux Nord AquitaineDavid Belada - Charles UniversityHervé Maisonneuve - Centre Hospitalier Départemental VendéeTanin Intragumtornchai - Chulalongkorn UniversityStephen M Ansell - Mayo ClinicThierry Lamy - Centre Hospitalier Universitaire de RennesPeggy Dartigues - Institut Gustave RoussyBrian K Link - University of IowaJohn F Seymour - Peter MacCallum Cancer CentreJames R Cerhan - Mayo Clinic in FloridaGilles Salles - Université Claude Bernard Lyon 1
- Resource Type
- Journal article
- Publication Details
- Blood, Vol.132(1), pp.49-58
- DOI
- 10.1182/blood-2017-11-816405
- PMID
- 29666118
- PMCID
- PMC6034646
- ISSN
- 0006-4971
- eISSN
- 1528-0020
- Grant note
- U01 CA195568 / NCI NIH HHS P30 CA086862 / NCI NIH HHS P50 CA097274 / NCI NIH HHS
- Language
- English
- Date published
- 07/05/2018
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9984359824702771
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