Prognostic factors in follicular lymphoma: the importance of beta-2 microglobulin.
OBJECTIVE
The Follicular Lymphoma International Prognostic Index (FLIPI) is a useful tool for the prognostic assessment of follicular lymphoma but beta-2 microglobulin (B2M) was not incorporated in this index. We aimed to compare the predictive value of B2M, FLIPI and other prognostic factors not included in the FLIPI index for overall survival (OS), complete remission (CR), and time to treatment failure (TTF) in a nonselected follicular lymphoma series.


METHODS
Retrospective univariate and multivariate analysis of the prognostic value (for OS, CR, TTF) of B2M, FLIPI and other prognostic variables in follicular lymphoma was conducted in a cohort of follicular lymphoma patients between 1987 and 2007.


RESULTS
One hundred and six patients were studied. In univariate analysis B2M and B symptoms were significantly associated with OS, and FLIPI only detected two risk levels. In multivariate analysis of OS only two significant variables were found: FLIPI and B2M. Multivariate analysis of CR showed that normal B2M, absence of a bulky mass, uninvolved bone marrow, and chemotherapy with rituximab were significant predictors of CR. FLIPI (three levels), B2M, bone marrow infiltration, and chemotherapy with rituximab were significantly associated with TTF.


CONCLUSIONS
We found a high predictive value of B2M for OS, CR, and TTF. B2M and FLIPI were the most important variables to predict OS. However, in our series FLIPI differentiated only between two mortality risk levels.
Cánovas
Araceli
A
Department of Internal Medicine, Hospital de Cruces, Faculty of Medicine (UPV) Baracaldo, Vizcaya, Spain. aracelicanovas@telefonica.net
Alonso
Juan J
JJ
Barreiro
Guillermo
G
Aguirre
Ciriaco
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008224:Lymphoma, Follicular / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D000069283:Rituximab; D017211:Treatment Failure; D016896:Treatment Outcome; D001613:beta 2-Microglobulin / Q000097:blood*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D007155:Immunologic Factors; D001613:beta 2-Microglobulin; D000069283:Rituximab