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Annals of Oncology 13:523-530, 2002
© 2002 European Society for Medical Oncology

Original Paper

Survival after progression in patients with follicular lymphoma: analysis of prognostic factors

S. Montoto1, A. López-Guillermo1,+, A. Ferrer1, M. Camós1, A. Álvarez-Larrán1, F. Bosch1, J. Bladé1, F. Cervantes1, J. Esteve1, F. Cobo1, D. Colomer2, E. Campo2 and E. Montserrat1

1Department of Hematology and 2Hematopathology Unit, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain

Received 6 August 2001; revised 6 November 2001; accepted 19 November 2001.

Background

The purpose of this study was to identify prognostic parameters for patients with follicular lymphoma (FL) in first progression/relapse. These would be useful for selection of high-risk patients for inclusion in trials aimed at determining the effect of new treatment approaches in such patients.

Patients and methods

Ninety patients (48 male, 42 female, median age 56 years) diagnosed with FL, in a single institution during a 20 year period and relapsing/progressing after an initial response to therapy, were recruited. The main end-point of the study was survival from progression (SFP). Univariate and multivariate analyses were performed, including among the predictive variables the response duration (RD) after the initial treatment and the main features of the patients at the first progression or relapse.

Results

Five-year SFP was 47% (95% confidence interval 35% to 58%). Patients with RD following initial therapy >2 years had a longer SFP (5-year SFP 63 versus 33%, P = 0.012). Other variables with prognostic interest for SFP were stage at diagnosis and the following variables at relapse: age, bulky disease, performance status, serum lactate dehydrogenase level, serum ß2-microglobulin level, bone marrow involvement, stage and International Prognostic Index rating. In the multivariate analysis, poor performance status at progression and a RD <2 years were the most important unfavorable variables to predict SFP.

Conclusion

In patients with FL, RD along with performance status at progression are features that predict SFP. These variables could thus be useful to select candidates for experimental treatments.

Key words: follicular lymphoma, outcome, progression


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