[Br J Haematol] Disease status of follicular lymphoma at 24 months affects mortality

Although life expectancy in patients with follicular lymphoma (FL) has improved significantly over the past 20 years, about 20% of patients develop disease progression (POD24) within 24 months of first-line therapy, and this early progression has been shown to be an independent risk factor
for low survival.

To assess the link between disease status, mortality and causes of death in FL patients at 24 months, Finnish scholars conducted a real-world, multicenter retrospective study of 704 eligible patients, recently published in the British Journal of Haematology
.

The result

The flow of patients included in the study is as follows

The median age at diagnosis was 60 years, and about two-thirds of patients (65.

With a median follow-up of 67 months, 217 patients died, 50.

The non-POD24 patient group was followed up for more than 10 years and found that it did not decrease over time (Figure 1A
).

Across the study population, deaths from lymphoma progression and other causes of cumulative mortality were similar (Figure 2A
).

In addition, the duration of the first remission also has an impact on the later course of the disease, as DSS is better than that of patients with POD24 after second-line therapy (figure below).

marry

In this real-world population, the mortality rate from lymphoma progression is similar to that of other causes; Patients with POD24 die mainly from lymphoma progression, similar
to the results of previous studies.

Given that both PFS and OS are prolonged in FL patients, many scholars are exploring reliable prediction of early alternative endpoints for OS, and event-free survival at 24 months and CR at 30 months are associated
with a good prognosis.

The prognosis of patients with non-POD24 is good, and their treatment priority should be to minimize the lifetime treatment burden and chemotherapy-related toxicity, as excess mortality includes not only deaths from lymphoma progression, but also treatment-toxicity-related deaths; Conversely, POD24 patients have an early risk of death due to lymphoma progression, so more aggressive treatment is justified, but it is also accompanied by higher treatment-related mortality and morbidity and increased social costs
.

References

Aino Rajamäki ,et al.

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