Clinical characteristics, treatment patterns and outcomes of patients with follicular lymphoma in Colombia: a real-world evidence cohort study

Follicular lymphoma (FL) is the second most common mature B lymphoid neoplasm. Understanding its epidemiology and clinical features is crucial for developing healthcare strategies, especially in low-and middle-income countries. This retrospective study analyzed clinical features, treatment patterns and outcomes of FL patients in a Colombian Health Maintenance Organization from 2018 to 2023. Statistical analyses were descriptive; survival was assessed using the Kaplan-Meier method. A total of 406 patients were included (mean age: 55.7 ± 13.8 years; 59.4% women). 79% of patients were classified as Ann Arbor stage III-IV, and 35% as high-risk in the FLIPI score. Most frequent first line (1 L) treatments were R-CHOP (63.5%) and R-CVP (10.8%), with 77.3% of patients achieving complete response (CR). Progression to second line (2L) therapy occurred in 30% of patients; 82% achieved CR. Most frequent 2L treatments were radiotherapy (23%), obinutuzumab-based regimens (18%) and R-Bendamustine (18%). Five-year progression-free survival was 70.4%, and overall survival at 5 and 10 years was 92% and 85%, respectively. A lower risk of death was observed in patients with low-intermediate FLIPI compared to patients with high FLIPI (HR = 0.23; 95%CI: 0.11-0.49). Patients with progression in the first 24 months (POD24) had a higher risk of mortality (HR = 6.54; 95%CI = 2.73-15.43). We report an approximation of the current status of FL in Colombia. Findings showed high response rates to initial treatment and prolonged overall survival. The presence of a high FLIPI score and POD24 were associated with an increased risk of mortality.