Long-term survival and prognostic analysis of advanced stage follicular lymphoma in the rituximab era: A China single-center retrospective study


Asia Pac J Clin Oncol. 2020 Sep 24. doi: 10.1111/ajco.13463. Online ahead of print.


AIM: The prognosis and treatment options for follicular lymphoma (FL) remain heterogenous. This study aimed to analyze the prognostic impact of rituximab maintenance and evaluate the prognostic models in Chinese FL patients.

METHODS: We retrospectively evaluated patients with treatment-naïve advanced stage FL who were treated in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College between January 2008 and December 2018. We compared the baseline characteristics, long-term survival outcomes, prognostic factors and the performance of four common prognostic models (i.e., FLIPI, FLIPI2, PRIMA-PI and LDH+β2M) between them.

RESULTS: A total of 158 patients were included (rituximab maintenance group, 77 patients; observation group, 81 patients). The median follow-up time was 61.0 months. The rituximab maintenance group showed significantly higher 5-year progression-free survival (PFS; 83.3% vs 52.7%, P < 0.001) and overall survival (OS; 97.8% vs 84.1%, P = 0.032) than the observation group. FLIPI2 showed a more discriminating C index than the other three models.

CONCLUSION: This study showed that rituximab maintenance after chemoimmunotherapy induction can prolong both PFS and OS in patients with advanced-stage FL, and FLIPI2 is a promising prognostic model.