LTB ‐ TREAT : A validated international prognostic model for time to treatment in low tumour burden follicular lymphoma
Watchful waiting (WW) in low tumour burden follicular lymphoma (LTB FL) defers treatment. There is a need to develop a model to predict time to treatment (TTT). We aimed to develop and externally validate a model for TTT in LTB FL. We conducted a retrospective analysis across eight centres within the Australasian Lymphoma Alliance. Two hundred and twenty-nine patients were included between 2004 and 2022 with a median follow-up of 5.0 years (range 0.5-17.8 years) and a median age was 64 years. All patients were Group d'Etude des Lymphomes Folliculaires (GELF) negative and managed with WW. Elevated lactate dehydrogenase and >4 nodal areas were independent prognostic factors associated with shorter TTT. These factors formed a prognostic model identifying three groups: low 59% (median TTT 6.34 years), intermediate 36% (median TTT 4.08 years), high risk 5% (median TTT 1.49 years) (p < 0.001). There was a higher incidence of serious complications among risk groups (low 7.5% vs. intermediate 13.3% vs. high 25%; p = 0.096). The prognostic value of the LTB-TREAT model was confirmed in an external validation cohort. The low-risk group is predicted to have a prolonged TTT with WW and a high-risk group is predicted to experience early progression in whom treatment should be considered.
Authors
- Lukshe Kanagaratnam (ORCID: https://orcid.org/0000-0003-3685-8407)
- Eliza A. Hawkes (ORCID: https://orcid.org/0000-0002-0376-2559)
- Sylvain Choquet (ORCID: https://orcid.org/0000-0002-7791-0470)
- Cyrielle Rodier
- Adrien Chauchet (ORCID: https://orcid.org/0000-0003-3665-6805)
- Lachlan Webb (ORCID: https://orcid.org/0000-0002-5209-0314)
- Adélie Herbin
- Caitlyn Nguyen‐Ngo (ORCID: https://orcid.org/0000-0002-1985-5741)
- Éric Durot (ORCID: https://orcid.org/0000-0003-3463-0089)
- Abir Bhattacharyya (ORCID: https://orcid.org/0000-0001-9070-5028)
- Denise Lee (ORCID: https://orcid.org/0000-0001-5338-275X)
- Helen Cashman (ORCID: https://orcid.org/0000-0002-3595-4256)
- Luani Barge (ORCID: https://orcid.org/0000-0002-3698-7383)
- Chan Yoon Cheah (ORCID: https://orcid.org/0000-0001-7988-1565)
- Nada Hamad (ORCID: https://orcid.org/0000-0001-7929-1450)
- Greg Hapgood (ORCID: https://orcid.org/0000-0002-7980-8496)
- Ross Salvaris (ORCID: https://orcid.org/0000-0003-1053-5503)
- Kirk Morris
- Sam Lai
- Tessa Potezny (ORCID: https://orcid.org/0000-0003-1124-9656)
- Niamh Waters
- Costas K. Yannakou
- Anita Pelecanos
- Constantine S. Tam
- Joshua Tobin
- Cédric Rossi
Institutions
- Box Hill Hospital (AU)
- The University of Queensland (AU)
- Université de Bourgogne (FR)
- QIMR Berghofer Medical Research Institute (AU)
- Royal Brisbane and Women's Hospital (AU)
- Epworth Hospital (AU)
- Princess Alexandra Hospital (AU)
- The Alfred Hospital (AU)
- Sir Charles Gairdner Hospital (AU)
- Westmead Hospital (AU)
- Sorbonne Université (FR)
- St Vincent's Hospital Sydney (AU)
- Centre Hospitalier Universitaire de Besançon (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Centre Hospitalier Universitaire de Reims (FR)
- CHU Dijon Bourgogne (FR)
- Pitié-Salpêtrière Hospital (FR)
- Hôpital Robert-Debré (FR)
- Olivia Newton-John Cancer Wellness & Research Centre (AU)
- Université de Reims Champagne-Ardenne (FR)
Publication Details
- Journal
- British Journal of Haematology
- Published
- 2026-08-27
- DOI
- https://doi.org/10.1111/bjh.70748
- Primary Topic
- Lymphoma Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00