Follicular Lymphoma International Prognostic Index 2: A New Prognostic Index for Follicular Lymphoma Developed by the International Follicular Lymphoma Prognostic Factor Project

Federico, Massimo; Bellei, Monica; Marcheselli, Luigi; Luminari, Stefano; López‐Guillermo, Armando; Vitolo, Umberto; Pro, Barbara; Pileri, Stefano; Pulsoni, Alessandro; Soubeyran, Pierre; Cortelazzo, Sergio; Martinelli, Giovanni; Martelli, Maurizio; Rigacci, Luigi; Arcaini, Luca; Raimondo, Francesco Di; Merli, Francesco; Sabattini, Elena; McLaughlin, Peter; Solal‐Céligny, Philippe

doi:10.1200/jco.2008.21.3991

Cited by 644 publications

(445 citation statements)

References 31 publications

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“…19 In our series, we found significant differences between low/intermediate (o3), and high-risk FLIPI groups (Z3) in terms of overall survival. Although currently the FLIPI 2 score is used, 20 we were unable to apply this type of score in our cases due to incomplete availability of some clinical and biological parameters, which were not routinely collected at the time of diagnosis. These included size of the largest tumor mass and serum b2-microglobulin level.…”

Section: Discussionmentioning

confidence: 99%

Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients

et al. 2013

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Follicular lymphoma is clinically heterogenous, and therefore necessitates the identification of prognostic markers to stratify risk groups and optimize clinical management. It is relatively rare in patients younger than 40 years, and the clinicopathologic characteristics and biological behavior in this age group are poorly understood. In the current study, samples from a cohort of 200 patients between 19 and 40 years were evaluated retrospectively with respect to clinical, histologic, and genetic features. These were then correlated with clinical outcome. The median age at presentation was 35 years with a slight female prepoderance (56%). Most of the cases are presented with nodal disease (90%). Concomitant follicular lymphoma and diffuse large B-cell lymphoma were observed in 7 (4%) patients. Immunohistologic studies showed the expression of CD10 (91%), BCL6 (97%), BCL2 (95%), MUM1/IRF4 (12%), MDM2 (17%), and CD23 (25%). BCL2 rearrangement was present in 74%, and BCL6 in 20%. The estimated overall survival of patients was 13 years (mean). The presence of anemia, elevated lactose dehydrogenase, bone marrow involvement, and high-risk follicular lymphoma international prognostic index correlated with adverse overall survival. Our findings revealed that follicular lymphoma in young adults demonstrate similarities with that of older adults, including the frequency of presentation at various anatomic sites, grade, and adverse prognostic factors.

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Section: Discussionmentioning

confidence: 99%

Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients

et al. 2013

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“…The distribution of IELSG-19 patients according to the 3 risk groups, corresponding to 42% (low), 41% (intermediate), and 17% (high) of the evaluated population, is similar to those reported for FLIPI and MIPI. 5,7,8 Five-year OS rates were 99%, 93%, and 64%, respectively, showing the greatest discrimination for the high-risk group.…”

Section: Discussionmentioning

confidence: 99%

A MALT lymphoma prognostic index

Thiéblemont

Cascione

Conconi

et al. 2017

Blood

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There are no widely accepted prognostic indices for extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). This study aimed to develop and validate a specific prognostic tool to personalize and optimize lymphoma treatment of patients with MALT lymphoma. A prognostic index was built by Cox regression (stepwise selection) using data from 401 patients enrolled in the international randomized IELSG-19 trial (NCT 00210353). A validation set, including 633 patients, was obtained by merging three independent cohorts of MALT lymphoma patients. The three individual features maintaining the greatest prognostic significance for event-free survival (EFS, the main endpoint of the IELSG-19 trial) were age ≥70 years (HR 1.72, 95% CI 1.26-2.33), Ann Arbor stage III or IV (HR 1.79, 95% CI 1.35-2.38), and elevated LDH level (HR 1.87, 95% CI 1.27-2.77). The prognostic index (MALT-IPI) constructed using these three parameters identified three groups: low, intermediate and high risk (corresponding to the presence of 0, 1 or ≥2 of these factors, respectively). The 5-year EFS rates in the low, intermediate and high risk groups were 70%, 56% and 29%, respectively. The MALT-IPI also significantly discriminated between patients with different progression-free, overall and cause-specific survival. The prognostic utility was retained in gastric and non-gastric lymphomas, in each treatment arm (chlorambucil, rituximab, rituximab plus chlorambucil), and was confirmed in the validation set. The new index, MALT-IPI, is a simple, accessible and effective tool to identify MALT lymphoma patients at risk of poor outcomes. It may help define appropriate treatment approaches for individual patients

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“…The procedure was repeated 1,000 times. 18 Since the model gave the lowest error with five or six covariates, we choose the five covariates more frequently included, i.e., tumor size (100%), node status (99%), grading (97%), HER2 status (85%) and estrogen receptor status (64%). The subsequent covariates, angioinvasion (38%), association with DCIS (37%), proliferative activity (31%), progesterone receptor (30%), multifocality (13%) and age (8%) were excluded from the multivariate analysis since had a low frequency and high rate of error.…”

Section: Prognostic Model Developmentmentioning

confidence: 99%

Tumor size, node status, grading, HER2 and estrogen receptor status still retain a strong value in patients with operable breast cancer diagnosed in recent years

Cortesi

Marcheselli

Guarneri

et al. 2012

Intl Journal of Cancer

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Breast cancer prognosis has improved greatly in recent years. Consequently, a thorough search for sensitive prognostic factors, able to help clinicians offer appropriate therapy, has become a priority in this area. In this study, we considered all new cases of invasive breast cancer diagnosed in the Province of Modena, Italy, between 1997 and, registered by the Modena Cancer Registry. The principal endpoint of this study was relapse-free survival (RFS). A set of 11 clinic and pathological parameters was investigated. After a median follow-up of 73 months, 494 relapses were recorded. Tumor size, node status, grading, HER2 and estrogen receptor status were retained as independent factors in a multivariate analysis. Using these variables, a prognostic model was devised to identify three groups at different risk. In the training sample, the 5-year RFS rates resulted 96.0%, 82.9% and 63.7% in patients at low, intermediate and high risk, respectively (p < 0.0001). In the validation sample, the 5-year RFS was 96.2%, 85.4% and 66.9%, respectively. To conclude our study demonstrates that a very simple prognostic index based on easily available clinical data may represent a useful tool for the identification of patients at different risk of relapse and may be a notable device to predict who truly benefits from medical treatment.The adoption of wide-scale mammographic screening for the detection of breast cancer at an earlier phase of development has resulted in an increasing number of cases being diagnosed at a very early stage, together with a reduction in breast cancer morbidity and mortality.1-3 However, the risk that screendetected cancer can lead to overdiagnosis in up to 24% of the cases, has been recently suggested. 4,5 Moreover, the introduction of the sentinel node procedure 6-8 has led to an increase in the detection rate of small lymph node metastases, due to more accurate pathological assessment that include step sectioning 9,10 and immunohistochemistry. 11 Finally, the new drugs and an enhanced tuning of already existing therapeutic approaches have contributed to a better disease control.Consequently, a thorough search for more sensitive prognostic factors, able to help clinicians offer appropriate adjuvant therapy after surgery, balancing the benefits of the prevention of recurrence and the risks related with unnecessary treatment, has become a priority in this area.In the past, the recognition of prognostic factors was based on the retrospective analysis of archive data and results were limited by patient selection criteria, missing data, no inclusion of more recently reported parameters and outdated adjuvant therapies. Finally, although overall survival (OS) should be the optimal endpoint, in a disease with an increasing scarcity of events, it appears unrealistic and requires a very long follow-up period.For all these reasons, we collected an exhaustive set of clinical, laboratory, pathological and therapeutic information for all cases of breast cancer diagnosed in the Province of Modena, Northern Italy, w...

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Follicular Lymphoma International Prognostic Index 2: A New Prognostic Index for Follicular Lymphoma Developed by the International Follicular Lymphoma Prognostic Factor Project

Abstract: Follicular Lymphoma International Prognostic Index 2 is a simple prognostic index based on easily available clinical data and may represent a promising new tool for the identification of patients with FL at different risk in the era of immunochemotherapy.

Cited by 644 publications

References 31 publications

Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients

Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients

A MALT lymphoma prognostic index

Tumor size, node status, grading, HER2 and estrogen receptor status still retain a strong value in patients with operable breast cancer diagnosed in recent years

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