Clinical characteristics and outcomes of follicular lymphoma patients with extranodal involvement: analysis of a series of 1090 cases in China
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Zhijuan Lin [1] ; Jie Zha [1] ; Shuhua Yi [6] ; Zhifeng Li [1] ; Lingyan Ping [2] ; Xiaohua He [7] ; Liyuan Fan [1] ; Haifeng Yu [3] ; Zhong Zheng [4] ; Wei Xu [8] ; Feili Chen [9] ; Ying Xie [10] ; Biyun Chen [10] ; Huilai Zhang [11] ; Li Wang [8] ; Kaiyang Ding [5] ; Wenyu Li [9] ; Haiyan Yang [3] ; Weili Zhao [4] ; Lugui Qiu [6] ; Zhiming Li [7] ; Yuqin Song [2] ; Bing Xu [1]
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[1] First Affiliated Hospital of Xiamen University
First Affiliated Hospital of Xiamen University
China
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[2] Peking University Cancer Hospital
Peking University Cancer Hospital
China
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[3] University of Chinese Academy of Sciences
University of Chinese Academy of Sciences
China
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[4] Shanghai Institute of Hematology
Shanghai Institute of Hematology
China
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[5] Anhui Provincial Hospital
Anhui Provincial Hospital
China
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[6] State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Blood Diseases Hospital & Institute of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
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[7] Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China
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[8] Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
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[9] Lymphoma Division, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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[10] Shengli Clinical Medical College of Fujian Medical University, Department of Hematology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
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[11] Department of Lymphoma, Tianjin Medical University Cancer Hospital, Tianjin, China
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- Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 6, 2023, págs. 1821-1829
- Idioma: inglés
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Resumen
Background Follicular lymphoma (FL) is the most common indolent B cell lymphoma in the world. The clinical features of extranodal involvement in FL were never extensively described.
Methods We enrolled 1090 patients diagnosed as newly diagnosed FL at ten medical institutions in China from 2000 to 2020 and conducted this analysis and retrospectively explored clinical characteristics and outcomes of FL patients with extranodal involvement.
Results 400 (36.7%) patients with newly diagnosed FL had no extranodal involvement, 388 (35.6%) patients had one site of extranodal involvement, and 302 (27.7%) had two or more sites of involvement. Patients with >1 extranodal site had significantly worse PFS (p<0.001), as well as OS (p=0.010). The most common site of extranodal involvements was bone marrow (33%), followed by spleen (27.7%) and intestine (6.7%). In patients with extranodal involvement, multivariate Cox analysis found that male patients (p=0.016), poor performance status (p=0.035), increased LDH (p<0.001) and pancreas involvement (p<0.001) was associated with poor PFS, while the latter three factors were also associated with poor OS. Compared to patients with one site of extranodal involvement, patients with >1 site involvement (p=0.012) had 2.04-fold risk to develop POD24. In addition, multivariate Cox analysis found that the usage of rituximab was not associated with better PFS (p=0.787) or OS (p=0.191).
Conclusions Our cohort is large enough to have statistical significance in FL patients with extranodal involvement. Male sex, increased LDH, poor performance status, >1 extranodal site, as well as pancreas involvement indicated useful prognostic factors in the clinical setting.
