scholarly journals Prognostic value of the Follicular Lymphoma International Prognostic Index score in marginal zone lymphoma

Cancer ◽  
2012 ◽  
Vol 119 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Andreas Heilgeist ◽  
Fabienne McClanahan ◽  
Anthony D. Ho ◽  
Mathias Witzens-Harig
Keyword(s):  
Follicular Lymphoma ◽  
Prognostic Value ◽  
Marginal Zone ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Marginal Zone Lymphoma ◽  
Index Score ◽  
International Prognostic Index Score

The architectural pattern of FOXP3-positive T cells in follicular lymphoma is an independent predictor of survival and histologic transformation

Blood ◽  
2010 ◽  
Vol 115 (2) ◽  
pp. 289-295 ◽  
Author(s):  
Pedro Farinha ◽  
Abdulwahab Al-Tourah ◽  
Karamjit Gill ◽  
Richard Klasa ◽  
Joseph M. Connors ◽  
...  
Keyword(s):  
T Cells ◽  
Follicular Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Progression Free Survival ◽  
Tissue Microarrays ◽  
Index Score ◽  
Cell Distribution ◽  
Cell Content ◽  
International Prognostic Index Score

Abstract Previous studies of follicular lymphoma (FL) patients treated heterogeneously have suggested that decreased numbers of regulatory T cells correlates with improved survival. We studied advanced-stage FL patients from a single institution phase 2 trial. All patients were treated uniformly with multiagent chemotherapy and radiation. Tissue microarrays were constructed using diagnostic biopsies available in 105 patients and stained with CD4, CD8, CD25, and forkhead/winged helix transcription factor 3 (FOXP3) antibodies. Both cell content and cell distribution were evaluated. For all antibodies, there were cases with a predominant intrafollicular or perifollicular localization of cells (follicular pattern) while others displayed a diffuse pattern. The median follow-up of living patients was 17.1 years. The International Prognostic Index score predicted overall survival (OS; P = .004) but not risk of transformation (RT). Cell content did not impact survival, while immunoarchitectural patterns of CD4/CD8 were significant for progression-free survival (PFS; P = .056), CD25 for both PFS and OS (P = .002 and P = .024, respectively), and FOXP3+ predicted PFS, OS, and RT (P = .001, P < .001 and p = .002, respectively). A Cox multivariate model showed both International Prognostic Index score and FOXP3+ pattern were independent predictors of OS (P = .008 and P < .001, respectively), while only FOXP3+ pattern predicted RT (P = .004). We conclude that FOXP3+ cell distribution significantly predicts survival and RT in FL.

Validation of the Marginal Zone Lymphoma International Prognostic Index

2018 ◽  
Vol 98 (2) ◽  
pp. 457-464 ◽  
Author(s):  
Joohyun Hong ◽  
Junhun Cho ◽  
Young Hye Ko ◽  
Seok Jin Kim ◽  
Won Seog Kim
Keyword(s):  
Marginal Zone ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Marginal Zone Lymphoma

scholarly journals Short regimen of rituximab plus lenalidomide in follicular lymphoma patients in need of first-line therapy

Blood ◽  
2019 ◽  
Vol 134 (4) ◽  
pp. 353-362 ◽  
Author(s):  
Emanuele Zucca ◽  
Stephanie Rondeau ◽  
Anna Vanazzi ◽  
Bjørn Østenstad ◽  
Ulrich J. M. Mey ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Progression Free Survival ◽  
Complete Response ◽  
Clinical Cancer Research ◽  
International Prognostic Index Score ◽  
First Line Therapy ◽  
Phase 2 Trial ◽  
Grade 3

Abstract The SAKK 35/10 phase 2 trial, developed by the Swiss Group for Clinical Cancer Research and the Nordic Lymphoma Group, compared the activity of rituximab vs rituximab plus lenalidomide in untreated follicular lymphoma patients in need of systemic therapy. Patients were randomized to rituximab (375 mg/m2 IV on day 1 of weeks 1-4 and repeated during weeks 12-15 in responding patients) or rituximab (same schedule) in combination with lenalidomide (15 mg orally daily for 18 weeks). Primary end point was complete response (CR)/unconfirmed CR (CRu) rate at 6 months. In total, 77 patients were allocated to rituximab monotherapy and 77 to the combination (47% poor-risk Follicular Lymphoma International Prognostic Index score in each arm). A significantly higher CR/CRu rate at 6 months was documented in the combination arm by the investigators (36%; 95% confidence interval [CI], 26%-48% vs 25%; 95% CI, 16%-36%) and confirmed by an independent response review of computed tomography scans only (61%; 95% CI, 49%-72% vs 36%; 95% CI, 26%-48%). After a median follow-up of 4 years, significantly higher 30-month CR/CRu rates and longer progression-free survival (PFS) and time to next treatment (TTNT) were observed for the combination. Overall survival (OS) rates were similar in both arms (≥90%). Toxicity grade ≥3 was more common in the combination arm (56% vs 22% of patients), mainly represented by neutropenia (23% vs 7%). Addition of lenalidomide to rituximab significantly improved CR/CRu rates, PFS, and TTNT, with expected higher, but manageable toxicity. The excellent OS in both arms suggests that chemotherapy-free strategies should be further explored. This trial was registered at www.clinicaltrials.gov as #NCT01307605.

scholarly journals Cause of Death in Follicular Lymphoma in the First Decade of the Rituximab Era: A Pooled Analysis of French and US Cohorts

2019 ◽  
Vol 37 (2) ◽  
pp. 144-152 ◽  
Author(s):  
Clémentine Sarkozy ◽  
Matthew J. Maurer ◽  
Brian K. Link ◽  
Hervé Ghesquieres ◽  
Emmanuelle Nicolas ◽  
...  
Keyword(s):  
Overall Survival ◽  
Follicular Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Event Free Survival ◽  
Free Survival ◽  
International Prognostic Index Score ◽  
Treatment Related Mortality ◽  
Related Mortality

Purpose Although the life expectancy of patients with follicular lymphoma (FL) has increased, little is known of their causes of death (CODs) in the rituximab era. Patients and Methods We pooled two cohorts of newly diagnosed patients with FL grade 1-3A. Patients were enrolled between 2001 and 2013 in two French referral institutions (N = 734; median follow-up 89 months) and 2002 and 2012 in the University of Iowa and Mayo Clinic Specialized Program of Research Excellence (SPORE; N = 920; median follow-up 84 months). COD was classified as being a result of lymphoma, other malignancy, treatment related, or all other causes. Results Ten-year overall survival was comparable in the French (80%) and US (77%) cohorts. We were able to classify COD in 248 (88%) of 283 decedents. In the overall cohort, lymphoma was the most common COD, with a cumulative incidence of 10.3% at 10 years, followed by treatment-related mortality (3.0%), other malignancy (2.9%), other causes (2.2%), and unknown (3.0%). The 10-year cumulative incidence of death as a result of lymphoma or treatment was higher than death as a result of all other causes for each age group (including patients ≥ 70 years of age at diagnosis [25.4% v 16.6%]) Follicular Lymphoma International Prognostic Index score 3 to 5 (27.4% v 5.2%), but not Follicular Lymphoma International Prognostic Index score 0 to 1 (4.0% v 3.7%); for patients who failed to achieve event-free survival within 24 months from diagnosis (36.1% v 7.0%), but not for patients who achieved event-free survival within 24 months of diagnosis (6.7% v 5.7%); and for patients with a history of transformed FL (45.9% v 4.7%), but not among patients without (8.1% v 6.2%). Overall, 77 of 140 deaths as a result of lymphoma occurred in patients whose FL transformed after diagnosis. Conclusion Despite the improvement in overall survival in patients with FL in the rituximab era, their leading COD remains lymphoma, especially after disease transformation. Treatment-related mortality also represents a concern, which supports the need for less-toxic therapies.

Numbers of Lymphoma Associated Macrophages (LAMS) and Regulatory T-Cells (Tregs) in Follicular Lymphoma (FL) Patients (pts) Treated with and without Monoclonal Antibody (MoAb)-Containing Therapy Do Not Correlate with Overall Survival (OS): A Study from the Southwest Oncology Group (SWOG).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2602-2602
Author(s):  
John William Sweetenham ◽  
Eric Hsi ◽  
Bryan Goldman ◽  
Michael LeBlanc ◽  
Raymond R. Tubbs ◽  
...  
Keyword(s):  
Overall Survival ◽  
Follicular Lymphoma ◽  
Prognostic Value ◽  
Cox Regression ◽  
International Prognostic Index ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Continuous Variables ◽  
Hazard Ratios ◽  
Anti Cd20

Abstract Introduction: Conflicting results have been reported for the prognostic value of LAMs and Tregs in FL. A recent study from the SWOG suggested that survival for pts with FL has improved in the last 30 years, possibly due to the introduction of MoAb-based therapy. We examined the prognostic significance of LAMs and FOX-P3-positive Tregs using tissue microarrays (TMAs) from pts entered onto SWOG studies 8809 (no MoAb) and 9911chemotherapy followed by (including 131I-tositumomab). Pts & methods: Adequate tissue samples were identified from 87 pts on SWOG 8809 and 47 on 9911. Pt characteristics were as follows: 8809: median age - 47.4 yrs (26.1 – 69.4), male 53%, Follicular Lymphoma International Prognostic Index (FLIPI) score: 1–36%, 2–39%, 3–21%. 9911: median age - 49.9 (22.9 – 66.8), male-60%, FLIPI score: 1–36%, 2–45%, 9–19%. The pts with available tissue were comparable with those who did not have available tissue for clinical prognostic factors. Archival blocks were reviewed to confirm FL and to assess for preparation of TMAs containing two 1mm diameter cores per case. Automated immunostaining for CD68 (PGM1) and FOXP3 (236A/E7) was performed. Intrafollicular (IF) and extra follicular (EF) LAMs were quantitated by manual count (5 1000x high power fields [hpf]). FOXP3 was scored for pattern (follicular/perfollicular vs. other) and number/5 hpf .LAM and Treg numbers/patterns were correlated with OS Marker levels were categorized by medians, 3rd quartiles and as continuous variables. Survival differences by marker level/pattern were assessed within each study population by Cox regression. Results: Pt characteristics did not differ by SWOG study. Hazard ratios with 95% confidence intervals for OS according to FOX-P3 and CD68 staining are shown in table 1. LAMS were not associated with OS, except for IF LAMS in S9911. Levels or pattern of FOX-P3 staining were not associated with OS. Conclusion: Levels of LAMs and Tregs were not predictive of overall survival in FL pts on SWOG trials before and after the introduction of anti-CD20 radio-immunotherapy (RIT). While IF LAMs in pts receiving RIT may be associated with shorter OS, the number of cases/events is too small for firm conclusions. Further studies are required to determine the prognostic value of these biomarkers in FL patients receiving anti-CD20 MoAb-containing therapies. Hazard ratios (95% CI) for OS for biomarker levels S8809 S9911 Overall * p&lt;0.05 FOX-P3 (follicular vs other) 0.66 (0.29, 1.46) 0.95 (0.11, 8.10) 0.69 (0.33, 1.46) FOX-P3 (above median vs below) 1.30 (0.66, 2.58) 0.60 (0.11, 3.26) 1.16 (0.62, 2.17) EF LAM (above median vs below) 1.24 (0.59, 2.61) 0.70 (0.16, 3.11) 1.11 (0.56, 2.18) EF LAM (above 3rd quartile vs below) 1.12 (0.42, 2.94) 0.64 (0.13, 3.32) 0.96 (0.41, 2.23) IF LAM (above median vs below) 0.79 (0.35, 1.76) 5.33 (1.03, 27.51)* 1.22 (0.58, 2.57) IF LAM (above 3rd quartile vs below) 1.38 (0.62, 3.06) 2.24 (0.43, 11.56) 1.50 (0.72, 3.11)

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