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Does Low-grade Follicular Lymphoma With a High Proliferation Index Require a Different Treatment Strategy? A Single
Rahim A Jiwani1, Eiraj Khan2, Hassan Abdulahi2
1AHN Cancer Institute, Division of Medical Oncology, Pittsburgh, PA, U.S.A.; rahimjiwani9@gmail.com.
Background/Aim:
Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma worldwide. Patients can have a wide range of clinical features and behavior which does not necessarily correlate to histologic grade or Ki-67 proliferation index. We hypothesized that patients with low grade but high proliferative index (LG/HP) FL have a more aggressive disease course. The aim of this study was to determine the role of LG/HP on the outcomes of FL patients.
Patients And Methods:
A retrospective single center study of FL patients treated within the Allegheny Health Network was conducted from January 2011 to December 2021. Patients were divided into three groups: low grade/high proliferation index (PI) (LG/HP), low grade/low PI (LG/LP), and high grade (HG). Cox regression models looking at variables including age, sex, race, Ann Arbor staging, PET SUVmax, FLIPI score, and treatment details were used to analyze predictors of progression. Survival estimates were calculated using the Kaplan-Meier method and compared using the Log-rank test.
Results:
A total of 145 patients were treated for FL during the study period. Most were males and fell into the LG/LP group. We determined that the median progression-free survival in the LG/HP group was numerically worse than the LG/LP group; however, this did not meet statistical significance.
Conclusion:
Our data suggest that a different treatment approach may not be warranted for LG/HP FL patients.
