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Peripheral blood involvement in patients with follicular lymphoma: a rare disease manifestation associated with poor prognosis

Abstract : Follicular Lymphoma (FL) is the second most common non-Hodgkin lymphoma (NHL) subtype and its course is heterogeneous. At diagnosis, some patients with FL manifest a detectable leukaemic phase (FL-LP), but this feature has been seldom described and is poorly characterized. Among 499 patients diagnosed with FL in Lyon-Sud hospital, 37 (7·4%) had characteristic FL-LP (by cytological blood smears and flow cytometric analysis). In addition, 91/1135 FL patients from the PRIMA study presented FL-LP at study entry. In order to evaluate the outcome of this Lyon-Sud cohort, FL-LP patients were matched with 111 newly diagnosed FL without LP according to the Follicular Lymphoma International Prognostic Index (FLIPI) score, age and treatment. Presence of FL-LP was associated with shorter progression-free survival (PFS) and overall survival (OS) (P = 0·004 and P = 0·031, respectively). Presence of FL-LP and high FLIPI score remained independent prognostic factors in a Cox model for time to progression (TTP). A number of circulating lymphoma cells (CLC) >4 × 109/l was the most significant predictor for a shorter TTP in this Cox model. The prognostic impact of FL-LP on TTP was validated in the PRIMA cohort (P = 0·0004). In conclusion, FL-LP is a rare event associated with shorter PFS and patients with CLC >4 × 109/l have a poorer outcome. These patients should be monitored carefully to consider alternative therapeutic options.
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https://hal.univ-lorraine.fr/hal-01698703
Contributor : Ngere Ul <>
Submitted on : Thursday, February 1, 2018 - 3:37:47 PM
Last modification on : Tuesday, October 13, 2020 - 10:45:55 AM

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Clémentine Sarkozy, Lucile Baseggio, Pierre Feugier, Evelyne Callet-Bauchu, Lionel Karlin, et al.. Peripheral blood involvement in patients with follicular lymphoma: a rare disease manifestation associated with poor prognosis. British Journal of Haematology, Wiley, 2014, 164 (5), pp.659 - 667. ⟨10.1111/bjh.12675⟩. ⟨hal-01698703⟩

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