title: Survival after progression in patients with follicular lymphoma: analysis of prognostic factors.
abstract: BACKGROUND
  The purpose of this study was to identify prognostic parameters for patients with follicular lymphoma (FL) in first progression/relapse. These would be useful for selection of high-risk patients for inclusion in trials aimed at determining the effect of new treatment approaches in such patients.
  
  
  METHODS
  Ninety patients (48 male, 42 female, median age 56 years) diagnosed with FL, in a single institution during a 20 year period and relapsing/progressing after an initial response to therapy, were recruited. The main end-point of the study was survival from progression (SFP). Univariate and multivariate analyses were performed, including among the predictive variables the response duration (RD) after the initial treatment and the main features of the patients at the first progression or relapse.
  
  
  RESULTS
  Five-year SFP was 47% (95% confidence interval 35% to 58%). Patients with RD following initial therapy >2 years had a longer SFP (5-year SFP 63 versus 33%, P = 0.012). Other variables with prognostic interest for SFP were stage at diagnosis and the following variables at relapse: age, bulky disease, performance status, serum lactate dehydrogenase level, serum beta2-microglobulin level, bone marrow involvement, stage and International Prognostic Index rating. In the multivariate analysis, poor performance status at progression and a RD <2 years were the most important unfavorable variables to predict SFP.
  
  
  CONCLUSIONS
  In patients with FL, RD along with performance status at progression are features that predict SFP. These variables could thus be useful to select candidates for experimental treatments.
authors.affiliation: Department of Hematology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Montoto
authors.forename: A
authors.initials: A
authors.lastname: López-Guillermo
authors.forename: A
authors.initials: A
authors.lastname: Ferrer
authors.forename: M
authors.initials: M
authors.lastname: Camós
authors.forename: A
authors.initials: A
authors.lastname: Alvarez-Larrán
authors.forename: F
authors.initials: F
authors.lastname: Bosch
authors.forename: J
authors.initials: J
authors.lastname: Bladé
authors.forename: F
authors.initials: F
authors.lastname: Cervantes
authors.forename: J
authors.initials: J
authors.lastname: Esteve
authors.forename: F
authors.initials: F
authors.lastname: Cobo
authors.forename: D
authors.initials: D
authors.lastname: Colomer
authors.forename: E
authors.initials: E
authors.lastname: Campo
authors.forename: E
authors.initials: E
authors.lastname: Montserrat
mesh_terms: D000367:Age Factors; D014408:Biomarkers, Tumor / Q000032:analysis; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor