title: Predictive value of Follicular Lymphoma International Prognostic Index (FLIPI) in patients with follicular lymphoma at first progression.
abstract: BACKGROUND
  Different prognostic scores have been proposed to predict the outcome of follicular lymphoma (FL) patients at diagnosis. A new prognostic index specifically addressing FL patients, the Follicular Lymphoma International Prognostic Index (FLIPI), has recently been developed, which might also be useful in patients with progression.
  
  
  METHODS
  One hundred and three patients (55 male, 48 female; median age 59 years) with FL in first relapse/progression after an initial response to therapy (50 complete responders/ 53 partial responders) were included in the study.
  
  
  RESULTS
  Five-year survival from progression (SFP) was 55% (95% confidence interval 44%-66%). The distribution according to the FLIPI at relapse was 39% good prognosis, 24% intermediate prognosis and 37% poor prognosis. Five-year SFP for these groups were 85%, 79% and 28%, respectively (P < 0.0001). Other variables at relapse with prognostic significance for SFP were age, presence of B symptoms, performance status, bulky disease, number of involved nodal sites, lactate dehydrogenase level, hemoglobin level, histological transformation, the Italian Lymphoma Intergroup prognostic index for FL and the International Prognostic Index for aggressive lymphomas. In the multivariate analysis bulky disease (P=0.01), presence of B symptoms (P=0.03) and FLIPI at relapse (P=0.0003) were the most important variables for predicting SFP.
  
  
  CONCLUSIONS
  In patients with FL at first relapse/progression, the FLIPI, along with the presence of bulky disease and B symptoms, are features that predict SFP and thus could be useful to select candidates for experimental treatments.
authors.affiliation: Department of Hematology and Hematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona.
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: Altés
authors.forename: G
authors.initials: G
authors.lastname: Perea
authors.forename: A
authors.initials: A
authors.lastname: Ferrer
authors.forename: M
authors.initials: M
authors.lastname: Camós
authors.forename: L
authors.initials: L
authors.lastname: Villela
authors.forename: F
authors.initials: F
authors.lastname: Bosch
authors.forename: J
authors.initials: J
authors.lastname: Esteve
authors.forename: F
authors.initials: F
authors.lastname: Cervantes
authors.forename: J
authors.initials: J
authors.lastname: Bladé
authors.forename: B
authors.initials: B
authors.lastname: Nomdedeu
authors.forename: E
authors.initials: E
authors.lastname: Campo
authors.forename: J
authors.initials: J
authors.lastname: Sierra
authors.forename: E
authors.initials: E
authors.lastname: Montserrat
mesh_terms: D000367:Age Factors; D000368:Aged; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008224:Lymphoma, Follicular / Q000145:classification* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D016019:Survival Analysis