The simplified follicular lymphoma PRIMA-prognostic index is useful in patients with first-line chemo-free rituximab-based therapy

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.

Lockmer, SandraKarolinska Inst, Dept Med Huddinge, Unit Hematol, S-14186 Stockholm, Sweden.;Karolinska Univ Hosp, Unit Hematol, Stockholm, Sweden. (author)
Holte, HaraldOslo Univ Hosp, Dept Oncol, Oslo, Norway.;KG Jebsen Ctr B Cell Malignancies, Oslo, Norway. (author)
Hagberg, HansUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)hanshagb (author)
Wahlin, Björn E.Karolinska Institutet (author)
Brown, PeterRigshosp, Dept Hematol, Copenhagen, Denmark. (author)
Östenstad, BjörnOslo Univ Hosp, Dept Oncol, Oslo, Norway. (author)
Karolinska InstitutetKarolinska Inst, Dept Med Huddinge, Unit Hematol, S-14186 Stockholm, Sweden.;Karolinska Univ Hosp, Unit Hematol, Stockholm, Sweden. (creator_code:org_t)

By the author/editor: Kimby, Eva; Lockmer, Sandra; Holte, Harald; Hagberg, Hans; Wahlin, Björn E.; Brown, Peter; show more...; Östenstad, Björn; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Hematology

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