Follicular lymphoma international prognostic index.
The prognosis of follicular lymphomas (FL) is heterogeneous and numerous treatments may be proposed. A validated prognostic index (PI) would help in evaluating and choosing these treatments. Characteristics at diagnosis were collected from 4167 patients with FL diagnosed between 1985 and 1992. Univariate and multivariate analyses were used to propose a PI. This index was then tested on 919 patients. Five adverse prognostic factors were selected: age (> 60 years vs < or = 60 years), Ann Arbor stage (III-IV vs I-II), hemoglobin level (< 120 g/L vs > or = 120 g/L), number of nodal areas (> 4 vs < or = 4), and serum LDH level (above normal vs normal or below). Three risk groups were defined: low risk (0-1 adverse factor, 36% of patients), intermediate risk (2 factors, 37% of patients, hazard ratio [HR] of 2.3), and poor risk (> or = 3 adverse factors, 27% of patients, HR = 4.3). This Follicular Lymphoma International Prognostic Index (FLIPI) appeared more discriminant than the International Prognostic Index proposed for aggressive non-Hodgkin lymphomas. Results were very similar in the confirmation group. The FLIPI may be used for improving treatment choices, comparing clinical trials, and designing studies to evaluate new treatments.
Solal-Céligny
Philippe
P
Centre Jean-Bernard, 9 rue Beauverger, 72000 Le Mans, France. p.solal-celigny@noos.fr
Roy
Pascal
P
Colombat
Philippe
P
White
Josephine
J
Armitage
Jim O
JO
Arranz-Saez
Reyes
R
Au
Wing Y
WY
Bellei
Monica
M
Brice
Pauline
P
Caballero
Dolores
D
Coiffier
Bertrand
B
Conde-Garcia
Eulogio
E
Doyen
Chantal
C
Federico
Massimo
M
Fisher
Richard I
RI
Garcia-Conde
Javier F
JF
Guglielmi
Cesare
C
Hagenbeek
Anton
A
Haïoun
Corinne
C
LeBlanc
Michael
M
Lister
Andrew T
AT
Lopez-Guillermo
Armando
A
McLaughlin
Peter
P
Milpied
Noël
N
Morel
Pierre
P
Mounier
Nicolas
N
Proctor
Stephen J
SJ
Rohatiner
Ama
A
Smith
Paul
P
Soubeyran
Pierre
P
Tilly
Hervé
H
Vitolo
Umberto
U
Zinzani
Pier-Luigi
PL
Zucca
Emanuele
E
Montserrat
Emili
E
D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis