Annals of Oncology Advance Access originally published online on August 28, 2006
Annals of Oncology 2006 17(10):1539-1545; doi:10.1093/annonc/mdl162
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2006 European Society for Medical Oncology
hematologic malignancies |
The Follicular Lymphoma International Prognostic Index (FLIPI) and the histological subtype are the most important factors to predict histological transformation in follicular lymphoma
Institute of Hematology and Oncology, Department of Hematology and Hematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
*Correspondence to: Dr A. López-Guillermo, Department of Hematology, Hospital Clínic Villarroel n° 170, 08036-Barcelona, Spain. Tel: +34-93-2275475. Fax: +34-93-2275484. E-mail: alopezg{at}clinic.ub.es
Background: Histological transformation (HT) is a well-known event in patients with follicular lymphoma (FL) conferring an unfavorable prognosis. The aim of the study was to analyze incidence and risk factors for HT in a large series of FL patients.
Patients and methods: 276 patients (median age: 54 years; M139/F137) diagnosed with FL (42% grade 1, 51% 2, 7% 3) in a single institution were studied. Initial treatment consisted of combined chemotherapy in most cases. Median survival was 11.3 years. Main clinic and biological variables were assessed for HT and survival.
Results: 30 of 276 patients (11%) presented HT after a median follow-up of 6.5 years, with a risk of 15% and 22% at 10 and at 15 years, respectively. All HT corresponded to diffuse large B-cell lymphoma (DLBCL). Grade 3 histology, nodal areas >4, increased LDH and ß2-microglobulin, and high-risk IPI and FLIPI were associated with HT. In multivariate analysis, grade 3 histology and FLIPI retained prognostic significance. Only FLIPI predicted HT in grade 12 patients. 28 patients received salvage treatment for HT, with a CR rate of 52%. Median survival from transformation was 1.2 years, with 6/13 CR patients being alive >5 years after HT.
Conclusion: FLIPI and histology were the most important variables predicting HT. Upon HT, only patients achieving CR reached prolonged survival, thus emphasizing the need for effective therapies once this event occurs.
Key words: follicular lymphoma, transformation, FLIPI
![]()
CiteULike
Connotea
Del.icio.us What's this?
This article has been cited by other articles:
![]() |
A. Noy, H. Schoder, M. Gonen, M. Weissler, K. Ertelt, C. Cohler, C. Portlock, P. Hamlin, and H. W. D. Yeung The majority of transformed lymphomas have high standardized uptake values (SUVs) on positron emission tomography (PET) scanning similar to diffuse large B-cell lymphoma (DLBCL) Ann. Onc., March 1, 2009; 20(3): 508 - 512. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. J. Al-Tourah, K. K. Gill, M. Chhanabhai, P. J. Hoskins, R. J. Klasa, K. J. Savage, L. H. Sehn, T. N. Shenkier, R. D. Gascoyne, and J. M. Connors Population-Based Analysis of Incidence and Outcome of Transformed Non-Hodgkin's Lymphoma J. Clin. Oncol., November 10, 2008; 26(32): 5165 - 5169. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Bendandi Aiming at a Curative Strategy for Follicular Lymphoma CA Cancer J Clin, September 1, 2008; 58(5): 305 - 317. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Federico, C. Guglielmi, S. Luminari, C. Mammi, L. Marcheselli, U. Gianelli, A. Maiorana, F. Merli, M. Bellei, S. Pozzi, et al. Prognostic relevance of serum {beta}2 microglobulin in patients with follicular lymphoma treated with anthracycline-containing regimens. A GISL study Haematologica, November 1, 2007; 92(11): 1482 - 1488. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. Klapper, E. Hoster, L. Rolver, C. Schrader, D. Janssen, M. Tiemann, H.-W. Bernd, O. Determann, M.-L. Hansmann, P. Moller, et al. Tumor Sclerosis but Not Cell Proliferation or Malignancy Grade Is a Prognostic Marker in Advanced-Stage Follicular Lymphoma: The German Low Grade Lymphoma Study Group J. Clin. Oncol., August 1, 2007; 25(22): 3330 - 3336. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Montoto, A. J. Davies, J. Matthews, M. Calaminici, A. J. Norton, J. Amess, S. Vinnicombe, R. Waters, A. Z.S. Rohatiner, and T. A. Lister Risk and Clinical Implications of Transformation of Follicular Lymphoma to Diffuse Large B-Cell Lymphoma J. Clin. Oncol., June 10, 2007; 25(17): 2426 - 2433. [Abstract] [Full Text] [PDF] |
||||



