Time to lymphoma treatment within 24 months in ‘watch and wait’ follicular lymphoma is associated with inferior outcomes: A multicentre analysis

Some 'watch and wait' (W&W) FL patients suffer from rapid progression in a short term. Herein, we sought to identify these patients and also develop a risk score to screen them at diagnosis. Between 2008 and 2022, a total of 411 FL patients managed by the W&W strategy from 16 cancer centres were retrospectively enrolled in this study, and their time to lymphoma treatment (TLT) and progression-free survival (PFS) were evaluated. Thirty-five percent of W&W FL patients experienced TLT within 24 months (TLT24) after diagnosis. Their 5-year PFS rate was significantly lower than those without treatment at 24 months (62.3% vs. 89.5%). In multivariable analysis, five factors were identified as independent predictors of TLT24: stages III-IV, β<sub>2</sub> microglobulin ≥3 mg/L, lymphocyte-to-monocyte ratio <3.8, bone marrow involvement and spleen enlargement (above umbilical line). Their AUCs for TLT24 were 0.76 (95% CI, 0.70-0.82) in the training cohort and 0.76 (95% CI, 0.67-0.85) in the validation cohort respectively. Risk groups were also associated with PFS (p < 0.001). In FL patients initially managed by W&W, TLT24 was associated with poor outcomes. This multivariable model helps screening for predicting TLT24, which may be useful to identify candidates for early interventional treatment.

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Publication Details

Journal
British Journal of Haematology
Published
2024-09-26
DOI
https://doi.org/10.1111/bjh.19770
Citations
1
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.42

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article

Time to lymphoma treatment within 24 months in ‘watch and wait’ follicular lymphoma is associated with inferior outcomes: A multicentre analysis

Lihua Qiu, Jiesong Wang, Zhiming Li, Liqun Zou et al.
1 citations
British Journal of Haematology
Lymphoma Diagnosis and Treatment
0.42
article

Time to lymphoma treatment within 24 months in ‘watch and wait’ follicular lymphoma is associated with inferior outcomes: A multicentre analysis

Lihua Qiu, Jiesong Wang, Zhiming Li, Liqun Zou, Bing Xu, Fenghua Gao, Hui Zhou, Lanfang Li, Xianhuo Wang, Rong Tao, Ou Bai, Zhengzi Qian, Tingting Zhang, Lihong Liu, Wei Zhang, Qingyuan Zhang, Shi-Yong Zhou, Yuqin Song, Liping Su, Shujuan Wen, Xudong Zhang, Xiuhua Sun, Jing Liu, Huilai Zhang
article en
1 citations

Abstract

Some 'watch and wait' (W&W) FL patients suffer from rapid progression in a short term. Herein, we sought to identify these patients and also develop a risk score to screen them at diagnosis. Between 2008 and 2022, a total of 411 FL patients managed by the W&W strategy from 16 cancer centres were retrospectively enrolled in this study, and their time to lymphoma treatment (TLT) and progression-free survival (PFS) were evaluated. Thirty-five percent of W&W FL patients experienced TLT within 24 months (TLT24) after diagnosis. Their 5-year PFS rate was significantly lower than those without treatment at 24 months (62.3% vs. 89.5%). In multivariable analysis, five factors were identified as independent predictors of TLT24: stages III-IV, β<sub>2</sub> microglobulin ≥3 mg/L, lymphocyte-to-monocyte ratio <3.8, bone marrow involvement and spleen enlargement (above umbilical line). Their AUCs for TLT24 were 0.76 (95% CI, 0.70-0.82) in the training cohort and 0.76 (95% CI, 0.67-0.85) in the validation cohort respectively. Risk groups were also associated with PFS (p < 0.001). In FL patients initially managed by W&W, TLT24 was associated with poor outcomes. This multivariable model helps screening for predicting TLT24, which may be useful to identify candidates for early interventional treatment.

British Journal of HaematologyVol. 205(5)
Hebei Medical University (CN), Fujian Medical University (CN), Central South University (CN), Xinjiang Medical University (CN), Harbin Medical University (CN), Sun Yat-sen University (CN), Shanxi Medical University (CN), Dalian Medical University (CN), Jilin University (CN), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Peking University (CN), Sichuan University (CN), Peking Union Medical College Hospital (CN), Tianjin Medical University Cancer Institute and Hospital (CN), First Affiliated Hospital of Xiamen University (CN), West China Hospital of Sichuan University (CN), Fudan University Shanghai Cancer Center (CN), Peking University Cancer Hospital (CN), Second Affiliated Hospital of Dalian Medical University (CN), Cangzhou Central Hospital (CN), Tumor Hospital of Xinjiang Medical University (CN), Third Affiliated Hospital of Harbin Medical University (CN), Fourth Hospital of Hebei Medical University (CN), Hunan Cancer Hospital (CN), First Hospital of Jilin University (CN), Peking University Third Hospital (CN), Sun Yat-sen University Cancer Center (CN), First Affiliated Hospital of Zhengzhou University (CN), Shanxi Academy of Medical Sciences (CN)
National Natural Science Foundation of China
Openalex Percentile: Top 35%
Lymphoma Diagnosis and Treatment
0.42
DOIOpen Access PDFOpenAlex
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