Follicular Lymphoma: Definition, Epidemiology, Pathobiology – Lymphomagenesis, Morphology, Variants, Immunophenotype, Prognostic Factors, Transformation

2020 ◽  
pp. 1-47
Author(s):  
Prabhjot Kaur
Keyword(s):  
Prognostic Factors ◽  
Follicular Lymphoma

scholarly journals Clinical and Biological Prognostic Factors in Follicular Lymphoma Patients During Treatment

2021 ◽  
Author(s):  
Ádám Jóna ◽  
Anna Kenyeres ◽  
Sándor Barna ◽  
Árpád Illés ◽  
Zsófia Simon
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Follicular Lymphoma ◽  
Risk Group ◽  
Standardized Uptake Value ◽  
Progression Free Survival ◽  
High Risk Group ◽  
Pet Ct ◽  
Significant Difference ◽  
Biological Prognostic Factors

Abstract Introduction: Follicular lymphoma (FL) is an indolent yet heterogeneous B-cell lymphoproliferative disorder. Most people respond to treatment well. However, a particular group of patients has a poor prognosis, and these patients are difficult to define.Patients and methods: We retrospectively analyzed FL patients treated at the University of Debrecen in the past 20 years. We investigated prognostic factors that may influence the survival of FL patients.Results: We found a standardized uptake value (SUV)max cut-off value of 9.85 at the staging PET/CT to significantly separate FL patients’ progression-free survival (PFS) (p=0.0003, HR: 0.2560, 95%CI: 0.1232-0.5318). Lymphocyte/ monocyte (Ly/Mo) ratio of 3.45 drawn at diagnosis also significantly predicted PFS (p=0.0324, HR: 1.806, 95% CI: 1.051-3.104). Combining patients’ with staging SUVmax >9.85 and Ly/Mo < 3.45 a high-risk group of FL patients can be identified (p<0.0001, HR: 0.1033, 95%CI: 0.03719-0.2868). Similarly, a significant difference was shown with a SUVmax cut-off of 3.15 at the interim PET/CT (p<0.0001, HR: 0.1535, 95%CI: 0.06329-0.3720). Combining patients with staging SUVmax >9.85 and interim SUVmax >3.15, a high-risk group of FL patients can be identified (p<0.0001, HR: 0.1037, 95%CI: 0.03811-0.2824). The PFS difference is translated into overall survival advantage (p=0.0506, HR: 0.1187, 95%CI: 0.01401-1.005).Discussion: Biological prognostic factors, such as the Ly/ Mo ratio, may improve the prognostic assessment of staging PET/CT. Nevertheless, PFS difference is translated into OS when using a combination of staging and interim SUVmax. We consider investigating additional biological prognostic factors while currently highlighting PET/CT's role in FL.

scholarly journals Follicular lymphoma patients with a high FLIPI score and a high tumor burden: A risk stratification model

2015 ◽  
Vol 72 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Bosko Andjelic ◽  
Milena Todorovic-Balint ◽  
Darko Antic ◽  
Jelena Bila ◽  
Vladislava Djurasinovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Histological Grade ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Tumor Burden ◽  
Cox Regression Analysis ◽  
High Tumor Burden

Background/Aim. The widely accepted Follicular Lymphoma International Prognostic Index (FLIPI) divides patients into three risk groups based on the score of adverse prognostic factors. The estimated 5-year survival in patients with a high FLIPI score is around 50%. The aim of this study was to analyse the prognostic value of clinical and laboratory parameters that are not included in the FLIPI and the New Prognostic Index for Follicular Lymphoma developed by the International Follicular Lymphoma Prognostic Factor Project (FLIPI2) indices, in follicular lymphoma (FL) patients with a high FLIPI score and high tumor burden. Methods. The retrospective analysis included 57 newly diagnosed patients with FL, a high FLIPI score and a high tumor burden. All the patients were diagnosed and treated between April 2000 and June 2007 at the Clinic for Hematology, Clinical Center of Serbia, Belgrade. Results. The patients with a histological grade > 1, erythrocyte sedimentation rate (ESR) ? 45 mm/h and hypoalbuminemia had a significantly worse overall survival (p = 0.015; p = 0.001; p = 0.008, respectively), while there was a tendency toward worse overall survival in the patients with an Eastern Cooperative Oncology Group (ECOG) > 1 (p = 0.075). Multivariate Cox regression analysis identified a histological grade > 1, ESR ? 45 mm/h and hypoalbuminemia as independent risk factors for a poor outcome. Based on a cumulative score of unfavourable prognostic factors, patients who had 0 or 1 unfavourable factors had a significantly better 5-year overall survival compared to patients with 2 or 3 risk factors (75% vs 24.1%, p = 0.000). Conclusion. The obtained results suggest that from the examined prognostic parameters histological grade > 1, ESR ? 45 mm/h and hypoalbuminemia can contribute in defining patients who need more aggressive initial treatment approach, if two or three of these parameters are present on presentation.

Follicular lymphoma prognostic factors in the modern era: what is clinically significant?

Hématologie ◽  
2011 ◽  
Vol 17 (3) ◽  
pp. 189-202
Author(s):  
Philippe Solal-Céligny ◽  
Xavier Cahu ◽  
Guillaume Cartron
Keyword(s):  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Clinically Significant ◽  
Modern Era

scholarly journals Prognostic value of lymphocyte-to-monocyte ratio and neutrophil-to-lymphocyte ratio in follicular lymphoma: a retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017904 ◽  
Author(s):  
Shing Fung Lee ◽  
Miguel Angel Luque-Fernandez
Keyword(s):  
Cohort Study ◽  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Lymphocyte To Monocyte Ratio

ObjectivesThe clinical course and prognosis of follicular lymphoma (FL) are diverse and associated with the patient’s immune response. We investigated the lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) as prognostic factors in patients with FL, including those receiving radiotherapy.DesignA retrospective cohort study.SettingRegional cancer centre in Hong Kong.Participants88 patients with histologically proven FL diagnosed between 2000 and 2014.Materials and methodsThe best LMR and NLR cut-off values were determined using cross-validated areas under the receiver operating characteristic curves. The extent to which progression-free survival (PFS) and overall survival differed by NLR and LMR cut-off values was assessed using Kaplan-Meier analysis and log-rank tests. A Cox proportional hazards model was fitted to adjust for confounders.ResultsThe best cut-off values for LMR and NLR were 3.20 and 2.18, respectively. The 5-year PFS was 73.6%. After multivariate adjustment, high LMR (>3.20) at diagnosis was associated with superior PFS, with a HR of 0.31 (95% CI 0.13 to 0.71), whereas high NLR at relapse was associated with poorer postprogression survival (HR 1.24, 95% CI 1.04 to 1.49).ConclusionsBaseline LMR and NLR at relapse were shown to be independent prognostic factors in FL. LMR and NLR are cheap and widely available biomarkers that could be used in combination with the Follicular Lymphoma International Prognostic Index by clinicians to better predict prognosis.

Clinical features of patients with nodal marginal zone lymphoma compared to follicular lymphoma: similar presentation, but differences in prognostic factors and rate of transformation

2015 ◽  
Vol 57 (7) ◽  
pp. 1649-1656 ◽  
Author(s):  
Michiel van den Brand ◽  
Walter J. F. M. van der Velden ◽  
Illja J. Diets ◽  
Geneviève I. C. G. Ector ◽  
Anton F. J. de Haan ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Clinical Features ◽  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Nodal Marginal Zone Lymphoma

The Architecural Pattern of FOXP3+ T Cells Predicts Risk of Transformation in Patients with Follicular Lymphoma (FL).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 358-358 ◽  
Author(s):  
Pedro Farinha ◽  
Abdul Al-Tourah ◽  
Joseph M. Connors ◽  
Randy D. Gascoyne
Keyword(s):  
T Cells ◽  
Prognostic Factors ◽  
Tumor Microenvironment ◽  
Follicular Lymphoma ◽  
Treg Cells ◽  
Clinical Event ◽  
Advanced Stage ◽  
Architectural Pattern ◽  
The Impact

Abstract Background: FL is an indolent heterogeneous lymphoid neoplasm with a variable clinical course. Transformation into an aggressive lymphoma (Tly) is a dominant clinical event frequently associated with inferior survival. No consistent biological markers have been identified that predict for Tly. Recent studies have highlighted the role of the microenvironment, including lymphoma-associated-macrophages (LAM) and Treg cells as important prognostic factors in FL. The nuclear expression of FOXP3 is considered a specific marker of regulatory T cells (Treg). However, most series have included pts variably treated with a wide spectrum of protocols. Using tissue microarrays (TMA) we recently demonstrated that both LAM content and follicular/perifollicular pattern of FOXP3+ T cells are independent adverse prognostic factors for both overall (OS) and progression-free (PFS) survival in advanced-stage FL patients treated uniformly with an aggressive regimen. However, the impact of either LAM or Tregs on Tly is largely unknown. Using the same cohort we assessed the role of these cell types for predicting Tly. Methods: Between 1987 and 1993, 126 pts were enrolled on a phase II study of BP-VACOP chemotherapy with involved region radiotherapy. All patients were treatment naïve, &lt; 61y and had advanced-stage FL. Paraffin blocks were available in 105 patients. The TMAs consisted of duplicate 1.0mm cores of diagnostic biopsies and were immunostained with both CD68 and a FOXP3-specific antibody. Both CD68+ macrophage content and FOXP3+ T cell content and immuno-architectural patterns were determined and correlated with RT including univariate and multivariate analyses. Results: There were 102 evaluable cases. The median follow-up of the living pts was 14.3 years and the estimated 10-year OS and Tly rates were 63% and 18%, respectively. The IPI was predictive of OS (RR = 2.4, 95% CI =1.4–4.2, p = 0.002) but not Tly (RR = 2.2, 95% CI =.9–5.1, p = 0.07). Histologic grade included 76 grade 1, 20 grade 2 and 6 grade 3a FLs. Cases revealed 1 to 28 CD68+ cells per high power field (median 7 cells/hpf) and zero to 731 FOXP3+ cells per core (median of 242 cells/core). In 38 pts there was a predominantly intrafollicular or perifollicular localization of positive cells (“follicular Treg pattern”) and in 64 pts the pattern was diffuse. Neither LAM content nor number of FOXP3+ cells had any impact on Tly. However, the immuno-architectural pattern of FOXP3+ cells was predictive of Tly, with the “follicular” pattern showing increased risk of Tly in univariate analysis (p=0.005). A Cox multivariate model including IPI and LAM showed only the FOXP3+ Treg pattern as an independent predictor of Tly (RR = 3.9, 95% CI =.1.5–9.9, p = 0.004). Conclusions: Treg cell distribution within the tumor is an important predictor of Tly in advanced-stage FL patients treated uniformly with an aggressive treatment regimen. Our results reinforce the importance of a FOXP3 follicular pattern as a good surrogate for functionally active Treg cells within the tumor microenvironment and further highlight the important role of the tumor microenvironment in FL biology. FOXP3+ T cells Architectural pattern & Risk of Transformation in Follicular Lymphoma (n=102) FOXP3+ T cells Architectural pattern & Risk of Transformation in Follicular Lymphoma (n=102)

IBCL-114: Clinical and Biological Prognostic Factors in Follicular Lymphoma Patients During Treatment

2021 ◽  
Vol 21 ◽  
pp. S401
Author(s):  
Ádám Jóna ◽  
Anna Kenyeres ◽  
Sándor Barna ◽  
Árpád Illés ◽  
Zsófia Simon
Keyword(s):  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Biological Prognostic Factors

scholarly journals Up-front rituximab maintenance improves outcome in patients with follicular lymphoma: a collaborative Nordic study

2018 ◽  
Vol 2 (13) ◽  
pp. 1562-1571 ◽  
Author(s):  
C. Madsen ◽  
M. R. Clausen ◽  
T. L. Plesner ◽  
A. Pasanen ◽  
T. Kuismanen ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Validation Cohort ◽  
Rituximab Maintenance ◽  
Key Points

Key PointsPatients who received R-chemo followed by MR had an improved 5-year PFS and OS independent of prognostic factors. A reduction of the risk of HT was observed among the MR patients of the training, but not of the validation, cohort.

scholarly journals Proteomic Analysis of Apoptotic Pathways Reveals Prognostic Factors in Follicular Lymphoma

2005 ◽  
Vol 11 (16) ◽  
pp. 5847-5855 ◽  
Author(s):  
Christian Gulmann ◽  
Virginia Espina ◽  
Emanuel Petricoin ◽  
Dan L. Longo ◽  
Mariarita Santi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Follicular Lymphoma ◽  
Proteomic Analysis ◽  
Apoptotic Pathways
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