Asian Pac J Cancer Prev. 2017 Mar 01;18(3):681-685. doi: 10.22034/APJCP.2017.18.3.681.
Follicular lymphoma: an Institutional Analysis.
Asian Pacific journal of cancer prevention : APJCP
Ajay Gogia, Vinod Raina, Lalit Kumar, Atul Sharma, Mehar Chand Sharma, Saumya Ranjan Mallick
Affiliations
Affiliations
- Department of Medical Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, India. Email: [email protected].
PMID: 28440975
PMCID: PMC5464484 DOI: 10.22034/APJCP.2017.18.3.681
Abstract
Background: Follicular lymphoma (FL) is second most common lymphoma in adult, constituted 20% of all lymphoma
cases in the west. There is limited information is available on FL from India. Methods: The clinico-pathological profile,
treatment outcome and prognostic factors for survival were assessed retrospectively in 181 patients of FL seen at our
center over a period of 17 years ( 1996-2012). Results: There were 120 males and 61 females. The median age was 51
years (24-80 years). The common presenting features were lymphadenopathy 71%, fatigue 23% and fever 20%. Ann
Arbor stage distribution was: stage I - 9%, stage II - 11%, stage III -22 % and stage IV - 58%. Extra nodal involvement
and bulky disease were present in 22% and 19% patients respectively. Follicular Lymphoma International Prognostic
Index (FLIPI) 1 score : Low -25%, Intermediate-45% and high risk in 30% of cases. One forty five patients (80%)
received treatment at presentation or during follow-up. Chemotherapeutic regimen used were: CHOP-45 , CVP-51,
chlorambucil and prednisolone -7 , BR ( bendamustine and rituximab)-12, RCHOP- 14 RCVP – 7 and other regimen
were used in 5 cases. The overall response (ORR) and complete remission (CR) rates were 70% and 35% respectively.
Median overall survival (OS) and event free survival (EFS) was 5.5 years and 2.5 years respectively, with median
follow up period of 3.0 years. Grade 3 histology, failure to attain CR, low serum albumin, and high risk FLIPI were
significantly associated with lower event free survival. High risk FLIPI (HR 1.46, 95% CI 1.03-2.10, p=0.003) and
failure to attain CR (HR 2.64, CI 1.10-4.30, p=0.001) were predictors of poor OS. Conclusions: FL represents 9 % of
all lymphoma in adult. This is the largest data from single institute from India. Eighty percentage of patients presented
in stage III/IV disease. High risk FLIPI and failure to attain CR were important prognostic variables for OS.
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Keywords: Follicular lymphoma; outcome; India
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