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The simplified follicular lymphoma PRIMA-prognostic index is useful in patients with first-line chemo-free rituximab-based therapy
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- Kimby, Eva (author)
- Karolinska Institutet
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- Lockmer, Sandra (author)
- Karolinska Inst, Dept Med Huddinge, Unit Hematol, S-14186 Stockholm, Sweden.;Karolinska Univ Hosp, Unit Hematol, Stockholm, Sweden.
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- Holte, Harald (author)
- Oslo Univ Hosp, Dept Oncol, Oslo, Norway.;KG Jebsen Ctr B Cell Malignancies, Oslo, Norway.
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- Karolinska Institutet Karolinska Inst, Dept Med Huddinge, Unit Hematol, S-14186 Stockholm, Sweden;Karolinska Univ Hosp, Unit Hematol, Stockholm, Sweden. (creator_code:org_t)
- 2020-05-14
- 2020
- English.
- In: British Journal of Haematology. - : WILEY. - 0007-1048 .- 1365-2141. ; 191:5, s. 738-747
- Journal article (peer-reviewed)
Abstract
Subject headings
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- Follicular lymphoma (FL) is a heterogeneous disease; therefore, reliable prognostic tools are needed to plan treatment strategies. The FL International Prognostic Index (FLIPI) was developed before the rituximab era, while the PRIMA-PI was built on rituximab chemotherapy. Our objective was to evaluate these two prognostic tools in a cohort of 291 patients with FL treated in two prospective randomised Nordic Lymphoma Group trials with rituximab +/- interferon. All patients had symptomatic/progressive disease and were previously untreated. The PRIMA-PI was prognostic for both time to treatment failure (TTF) and overall survival (OS) (log-rank P = 0 center dot 003 and P < 0 center dot 001, respectively). The PRIMA-PI high-risk identified a small group of patients with a very short TTF and OS compared to the low-risk group, with a hazard ratio (HR) of 1 center dot 90 (95% confidence interval [CI] 1 center dot 30-2 center dot 78, P = 0 center dot 001) and HR of 3 center dot 19 (95% CI 1 center dot 75-5 center dot 83, P < 0 center dot 001), respectively. The FLIPI risk groups were prognostic only for OS (log-rank P = 0 center dot 018). The simplified PRIMA-PI was valid in our FL cohort with first-line rituximab-containing chemo-free therapy and shows an improved risk stratification compared to the FLIPI, especially in patients aged >60 years. Patients in the PRIMA-PI high-risk group should be considered for alternative therapies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
Keyword
- follicular lymphoma
- prognosis
- rituximab
- chemo-free regimen
Publication and Content Type
- ref (subject category)
- art (subject category)
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- Kimby, Eva
- Lockmer, Sandra
- Holte, Harald
- Hagberg, Hans
- Wahlin, Björn E.
- Brown, Peter
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- Östenstad, Björn
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