Analysis On Clinical Features And Prognosis Of 117-Patients With Follicular Lymphoma

ObjectiveThis article aims to investigate the clinical features of patients with follicular lymphoma(FL)and the prognostic factors affecting progression-free survival(PFS)and overall survival(OS)in a single center.MethodsA retrospective analysis of 117 hospitalized(through January 01,2011 to April 30,2018)patients with follicular lymphoma in Fujian Medical University Union Hospital were performed.The recorded clinical characteristics,laboratory results,pathological markers,Treatment regimen,efficacy,and survival status were analyzed.All cases were assessed by risk stratification using the FLIPI scoring system,including Ann Arbor staging,age,Hb,LDH,number of involved lymph node.The efficacy of treatment was evaluated according to the evaluation criteria for malignant lymphoma(Lugano 2014 version).The prognostic factors including clinical features,laboratory results,pathological markers,and treatment were analyzed by univariate analysis and multivariate analysis.ResultsAmong the 117 patients with FL,the median age was 54 years old,including 54 males and 63 females(male: female=1:1.67),81(69.2%)patients had superficial lymphadenopathy as the first symptom;13(11.1%)patients had B symptoms;59(50.4%)patients had extranodal organ involved,including bone marrow involved 38 cases(32.4%);the rate of hepatitis B serological positive was 76.8%;the cases of grade 1-2 and grade 3 were 72(61.5%)and 38(32.4%),respectively.There were 5 cases of DLBCL transformation.There were 12cases(34.3%)with the positive rate of Bcl2/IgH gene rearrangement.Stage III-IV patients accounted for 74.3%.The number in high-risk group was 32(27.3%)according to FLIPI score.The median OS in all cases was not reached.The cumulative OS rates at 3,5,and 7 years were 95.4%,92.8%,and 69.6%,respectively.The median PFS in all cases was not reached,the cumulative PFS rates in 3 years,5 years,and 7 years were 70.6%,60.3%,and 60.3%,respectively.The ORR(CR+PR)of treatment was 88%,including CR 63%.The CR rate in the group.The CR rate with rituximab treatment was higher than that in the group with rituximab treatment(P<0.05).The cumulative OS and PFS rates in the rituximab treatment group were higher than that of the without rituximab treatment group(P>0.05).FLIPI score,LDH,blood β2 microglobulin,hemoglobin,and ORR status had a significant effect on OS according to univariate analysis(P<0.05);but gender,CD5 expression,ORR status was influence factors for PFS.(P < 0.05).showed FLIPI was an independent prognostic factor for OS(P<0.05),and gender was an independent prognostic factor for OS(P<0.05)according to multivariate analysis.ConclusionThe median age of 117 patients with FL was 54 years old,with women dominant.Superficial lymphadenopathy is the most common sign;The positive rate of hepatitis B serology was high,mostly in advanced stage,long survival time,but high recurrence rate;The positive rate of CD5 is high,CD5 expression is a poor prognostic factor;Rituximab treatment improves the OR rate,ORR,PFS and OS of patients with FL;FLIPI is an independent risk factor for OS;but gender is an independent risk factor for PFS in patients with FL.