title: Life expectancy of young adults with follicular lymphoma.
abstract: BACKGROUND
  This study was aimed at investigating the clinical features and outcomes of follicular lymphoma (FL) patients younger than 40 years, which have not been extensively investigated yet.
  
  
  METHODS
  One hundred and fifty-five patients younger than 40 years were retrospectively studied from a series of 1002 FL patients diagnosed in four different European Oncology Centres (Barcelona, Spain; Bellinzona, Switzerland; London, UK; Novara, Italy) from 1985 to 2010.
  
  
  RESULTS
  Patients younger than 40 had a lower incidence of elevated LDH, high beta2-microglobulin, and a high-risk Follicular Lymphoma International Prognostic Index (FLIPI) score, whereas bone marrow involvement and bulky and disseminated lymphadenopathy were more frequent. At a median follow-up of 10 years, younger patients, in comparison with those older than 40, had significantly better overall (OS), cause-specific survival (CSS), and progression-free survival (PFS), with 10-year OS rate of 81% versus 51% (P < 0.0001), 10-year CSS rate of 82% versus 60% (P < 0.0001), and 10-year PFS of 39% versus 24% (P = 0.0098). However, there were no significant CSS and PFS differences in comparison with the patients aged 40-60. In multivariate analysis, having the lymphoma diagnosed in the last two decades and a favourable FLIPI score were associated with a significantly longer PFS and CSS in younger patients, whereas only FLIPI retained statistical significance for OS.
  
  
  CONCLUSIONS
  In our series, FL patients younger than 40 have a median OS of 24 years and their outcome seems to be improving over time. However, they still have a significantly shorter life expectancy than that of an age-matched general healthy population.
authors.affiliation: Unit of Hematology, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Conconi
authors.affiliation: Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Lobetti-Bodoni
authors.affiliation: Barts Cancer Institute, Queen Mary University of London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Montoto
authors.affiliation: Institute of Hematology and Oncology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Lopez-Guillermo
authors.affiliation: Institute of Hematology and Oncology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Coutinho
authors.affiliation: Barts Cancer Institute, Queen Mary University of London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Matthews
authors.affiliation: Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Franceschetti
authors.affiliation: Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland Lymphoma and Genomics Research Program, Institute of Oncology Research (IOR), Bellinzona.
authors.forename: F
authors.initials: F
authors.lastname: Bertoni
authors.affiliation: Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Moccia
authors.affiliation: Lymphoma and Genomics Research Program, Institute of Oncology Research (IOR), Bellinzona Dalle Molle Institute for Artificial Intelligence (IDSIA), Manno-Lugano, Switzerland.
authors.forename: P M V
authors.initials: PM
authors.lastname: Rancoita
authors.affiliation: Barts Cancer Institute, Queen Mary University of London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gribben
authors.affiliation: Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Cavalli
authors.affiliation: Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gaidano
authors.affiliation: Barts Cancer Institute, Queen Mary University of London, London, UK.
authors.forename: T A
authors.initials: TA
authors.lastname: Lister
authors.affiliation: Institute of Hematology and Oncology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Montserrat
authors.affiliation: Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Ghielmini
authors.affiliation: Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland emanuele.zucca@eoc.ch.
authors.forename: E
authors.initials: E
authors.lastname: Zucca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008017:Life Expectancy / Q000639:trends*; D008131:London / Q000453:epidemiology; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage*; D013030:Spain / Q000453:epidemiology; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000069283:Rituximab
keywords: age; follicular lymphoma; life expectancy; prognosis; survival; young adults