Contributions
Abstract: EP794
Type: E-Poster Presentation
Session title: Indolent and mantle-cell non-Hodgkin lymphoma - Clinical
Background
Follicular lymphoma (FL) is an indolent non-Hodgkin’s lymphoma with heterogeneous outcomes. Progression of disease within 24 months (POD24) is strongly associated with poor outcome. Therefore, prediction of POD24 at diagnosis is essential to support the precision medicine treatment strategies making in clinical practice. However, risk factors associated with POD24 remain uncertain in FL patients.
Aims
To perform a systematic review and meta-analysis to identify the potential risk factors for POD24 in FL patients.
Methods
Comprehensive literature search in Embase, Medline and the Cochrane Library was performed from database inception to 1 September, 2020 to identify prognostic studies in patients with newly diagnosed grade 1-3a FL. The interested outcome was POD24. For studies not reporting POD24, we attempted to synthesize the association between risk factors and any progression within 24 months that defined by original studies. This study protocol has been registered on PROSPERO with registration number PROSPERO CRD42021231824.
Results
A total of 96 studies reporting 81 prognostic factors were included, among which 11 factors were eligible for meta-analysis. Results showed that elevated sIL-2R (HR 2.48; 95% CI, 1.74-3.54; p< 0.0001 [7 studies]), total metabolic tumor volume (TMTV) >510mL (HR 2.17; 95% CI, 1.60-2.95; p<0.0001, [5 studies]), elevated β2m (HR 4.14; 95% CI, 2.07-8.28; p<0.0001 [4 studies]), elevated LDH (HR 3.05; 95% CI, 1.63-5.71; p=0.0005, [4 studies]), grade 3a (HR 2.22; 95% CI, 1.31-3.74; p=0.0030, [3 studies]), lymphoma-associated macrophages (LAM)/ high -power field(HPF) ≥15 (HR =4.13; 95% CI, 1.92-8.88; p=0.0003, [2studies]), Vitamin D insufficiency (<20 ng/ml) (HR=2.66; 95% CI, 1.44-4.92; p=0.0020, [2studies]) were significantly associated with an increased risk of POD24. Absolute lymphocyte count (ALC)/Absolute monocyte count (AMC) ratio (cutoff:4.7) , sex, and EZH2 mutation status, effector T-cell gene expression (two studies for each factor) were found not to be significantly associated with POD24.
Conclusion
To our knowledge, this is the first study that comprehensively analyses the risk factors associated with POD24 in FL patients. Results from this meta-analysis confirmed significant association between 7 factors and POD24. Our findings may contribute to the development of an optimized risk stratification model of FL POD24 in the future.
Keyword(s): Follicular lymphoma, Meta-analysis, Progression, Risk factor
Abstract: EP794
Type: E-Poster Presentation
Session title: Indolent and mantle-cell non-Hodgkin lymphoma - Clinical
Background
Follicular lymphoma (FL) is an indolent non-Hodgkin’s lymphoma with heterogeneous outcomes. Progression of disease within 24 months (POD24) is strongly associated with poor outcome. Therefore, prediction of POD24 at diagnosis is essential to support the precision medicine treatment strategies making in clinical practice. However, risk factors associated with POD24 remain uncertain in FL patients.
Aims
To perform a systematic review and meta-analysis to identify the potential risk factors for POD24 in FL patients.
Methods
Comprehensive literature search in Embase, Medline and the Cochrane Library was performed from database inception to 1 September, 2020 to identify prognostic studies in patients with newly diagnosed grade 1-3a FL. The interested outcome was POD24. For studies not reporting POD24, we attempted to synthesize the association between risk factors and any progression within 24 months that defined by original studies. This study protocol has been registered on PROSPERO with registration number PROSPERO CRD42021231824.
Results
A total of 96 studies reporting 81 prognostic factors were included, among which 11 factors were eligible for meta-analysis. Results showed that elevated sIL-2R (HR 2.48; 95% CI, 1.74-3.54; p< 0.0001 [7 studies]), total metabolic tumor volume (TMTV) >510mL (HR 2.17; 95% CI, 1.60-2.95; p<0.0001, [5 studies]), elevated β2m (HR 4.14; 95% CI, 2.07-8.28; p<0.0001 [4 studies]), elevated LDH (HR 3.05; 95% CI, 1.63-5.71; p=0.0005, [4 studies]), grade 3a (HR 2.22; 95% CI, 1.31-3.74; p=0.0030, [3 studies]), lymphoma-associated macrophages (LAM)/ high -power field(HPF) ≥15 (HR =4.13; 95% CI, 1.92-8.88; p=0.0003, [2studies]), Vitamin D insufficiency (<20 ng/ml) (HR=2.66; 95% CI, 1.44-4.92; p=0.0020, [2studies]) were significantly associated with an increased risk of POD24. Absolute lymphocyte count (ALC)/Absolute monocyte count (AMC) ratio (cutoff:4.7) , sex, and EZH2 mutation status, effector T-cell gene expression (two studies for each factor) were found not to be significantly associated with POD24.
Conclusion
To our knowledge, this is the first study that comprehensively analyses the risk factors associated with POD24 in FL patients. Results from this meta-analysis confirmed significant association between 7 factors and POD24. Our findings may contribute to the development of an optimized risk stratification model of FL POD24 in the future.
Keyword(s): Follicular lymphoma, Meta-analysis, Progression, Risk factor