New Prognostic System for Patients with Relapsed Follicular Lymphoma

A study of 1,567 patients with relapsed follicular lymphoma (FL) undergoing hematopoietic cell transplantation (HCT) between 2001 and 2011 has shown that these patients can achieve 5‐year overall and progression-free survival of 61% and 52%, respectively.

This retrospective analysis of HCT using HLA-matched donors also identified several prognostic factors associated with outcomes. Chemoresistant disease, older age, heavy pretreatment, poor performance status, and myeloablative conditioning regimens were significant predictors for worse survival. Consistent with previous studies and current practice guidelines, these factors suggest that patients with FL should be evaluated for HCT at an early disease stage.

The 5‐year cumulative incidences of disease progression/relapse and transplant-related mortality were 29% and 19%, respectively.

The researchers then developed a prognostic score to assess procedure-related risk based on age, lines of prior therapy, disease status and performance status. The prognostic score stratified patients into 3 groups – low, intermediate, and high risk – with 5‐year overall survival rates of 80%, 62%, and 50%, respectively.

The researchers concluded that allogeneic HCT should be considered for patients with relapsed FL and available HLA‐matched donors. Using a prognostic scoring system at an early disease stage, or at diagnosis, can assist in counseling patients in the decision to pursue consultation for HCT to determine the optimal timing based on patient risks.

Sureda A, et al. Cancer

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