Contributions
Abstract: PB1574
Type: Publication Only
Session title: Indolent and mantle-cell non-Hodgkin lymphoma - Clinical
Background
Indolent and aggressive lymphomas differ in clinical course with a short anamnesis and a rapid increase in tumor mass characterized for the latter. However, the factor oh the disease history duration (DHD) is not sufficiently studied within nosological forms. At present DHD as a factor of patient risk stratification is not included in any prognostic scale.
FL grade 3 is a very heterogeneous group of patients with different outcomes of the disease. So new stratification factors research is encouraged for FL grade 3 patients.
As genetic analysis is not readily available in general practice and, moreover, no key unfavorable genetic abnormalities have been identified for FL with an unfavorable prognosis, such a clinical parameter as DHD could be a feature reflecting the biological rate of tumor development.
Aims
To determine the prognostic value of DHD in patients with FL grade 3 and transformation of FL into large-cell lymphoma.
Methods
The medical histories of 257 patients with FL high-grade from 1998 to 2020 were analyzed. Based on DHD values the following groups of patients were formed: group 1, DHD less than 3 months (#85); group 2, DHD from 3 to 6 months (#72); group 3, DHD from 6 to 12 months (#49); group 4, DHD more than 12 months (#51). Statistical analysis was carried out in STATISTICA 12 software (StatSoft, USA). Pearson correlation, χ2 test, Kaplan-Meyer survival analysis, Log-Rank test were used. Overall (OS) and event-free (EFS) survival were studied as control points.
Results
When comparing four patients groups the lower OS and EFS in group 1 (Figure 1A) were noted. Survival rates in groups 2, 3, and 4 were almost identical, which allowed us to merge into them into general group G. The following statistically significant differences (p<0.05) were found between group 1 and group G: 3 year OS was 71% and 87%, and 10-year OS – 47% and 72%, respectively (Figure 1B). 3-year EFS in groups 1 and G were 38% and 61% and 10-year EFS –20% and 41%, respectively (are not illustrated).
The association of DHD and OS was also confirmed by the correlation analysis (r=0.23, p<0.05) (Figure 1C).
In the χ2 test, there were no differences between the groups in the following terms: FL grade, complete and partial remission or disease progression frequency, Ann-Arbor stage, bulky lymph nodes presence, bone marrow involvement, as well as immune chemotherapy regimen (high-dose therapy, CHOP, EPOCH and others). In group 1, the frequency of high risk FLIPI-1 values was slightly higher, but not statistically significant.
Thus, clinical features of patients groups with different DHD were comparable, which suggests a reliable association OS, EFS and DHD.
Conclusion
We suggest that the association of DHD and survival rates in FL patients is not only a clinical observation. Currently, the hematopoiesis chronology phenomenon is not sufficiently studied. This interesting area of hematology implies the existence of regular rhythms of cell differentiation. The tumor stem cell resting period and its proliferation activation time, in contrast to the normal precursor, are apparently individual and predetermined by the tumor genome. So DHD considered in the study may reflect this tumor chronological nature. In this regard, the relationship with patient survival rates becomes clear.
The practical result of this work is the identification of a new factor of unfavorable prognosis, which can potentially be used in FL prognostic scales design.
Keyword(s): Follicular lymphoma, Prognostic factor, Survival prediction
Abstract: PB1574
Type: Publication Only
Session title: Indolent and mantle-cell non-Hodgkin lymphoma - Clinical
Background
Indolent and aggressive lymphomas differ in clinical course with a short anamnesis and a rapid increase in tumor mass characterized for the latter. However, the factor oh the disease history duration (DHD) is not sufficiently studied within nosological forms. At present DHD as a factor of patient risk stratification is not included in any prognostic scale.
FL grade 3 is a very heterogeneous group of patients with different outcomes of the disease. So new stratification factors research is encouraged for FL grade 3 patients.
As genetic analysis is not readily available in general practice and, moreover, no key unfavorable genetic abnormalities have been identified for FL with an unfavorable prognosis, such a clinical parameter as DHD could be a feature reflecting the biological rate of tumor development.
Aims
To determine the prognostic value of DHD in patients with FL grade 3 and transformation of FL into large-cell lymphoma.
Methods
The medical histories of 257 patients with FL high-grade from 1998 to 2020 were analyzed. Based on DHD values the following groups of patients were formed: group 1, DHD less than 3 months (#85); group 2, DHD from 3 to 6 months (#72); group 3, DHD from 6 to 12 months (#49); group 4, DHD more than 12 months (#51). Statistical analysis was carried out in STATISTICA 12 software (StatSoft, USA). Pearson correlation, χ2 test, Kaplan-Meyer survival analysis, Log-Rank test were used. Overall (OS) and event-free (EFS) survival were studied as control points.
Results
When comparing four patients groups the lower OS and EFS in group 1 (Figure 1A) were noted. Survival rates in groups 2, 3, and 4 were almost identical, which allowed us to merge into them into general group G. The following statistically significant differences (p<0.05) were found between group 1 and group G: 3 year OS was 71% and 87%, and 10-year OS – 47% and 72%, respectively (Figure 1B). 3-year EFS in groups 1 and G were 38% and 61% and 10-year EFS –20% and 41%, respectively (are not illustrated).
The association of DHD and OS was also confirmed by the correlation analysis (r=0.23, p<0.05) (Figure 1C).
In the χ2 test, there were no differences between the groups in the following terms: FL grade, complete and partial remission or disease progression frequency, Ann-Arbor stage, bulky lymph nodes presence, bone marrow involvement, as well as immune chemotherapy regimen (high-dose therapy, CHOP, EPOCH and others). In group 1, the frequency of high risk FLIPI-1 values was slightly higher, but not statistically significant.
Thus, clinical features of patients groups with different DHD were comparable, which suggests a reliable association OS, EFS and DHD.
Conclusion
We suggest that the association of DHD and survival rates in FL patients is not only a clinical observation. Currently, the hematopoiesis chronology phenomenon is not sufficiently studied. This interesting area of hematology implies the existence of regular rhythms of cell differentiation. The tumor stem cell resting period and its proliferation activation time, in contrast to the normal precursor, are apparently individual and predetermined by the tumor genome. So DHD considered in the study may reflect this tumor chronological nature. In this regard, the relationship with patient survival rates becomes clear.
The practical result of this work is the identification of a new factor of unfavorable prognosis, which can potentially be used in FL prognostic scales design.
Keyword(s): Follicular lymphoma, Prognostic factor, Survival prediction