An international cooperative study has developed a prognostic index for patients with follicular lymphoma. Using 5 factors, the researchers were able to predict patients with a less than 50% 5-year survival who would be suitable candidates for more intensive therapy. This paper was published in the September 1, 2004 issue of Blood .

This international study grew out of the need to identify patients with follicular lymphoma who have a relatively poor outcome with conventional treatment. Identification of such patients would allow for testing more intensive therapies such as autologous or allogeneic stem cell transplants.

The 5 risk factors included in the final model were developed in 1,647 patients: Age 60 or over, Ann Arbor stage III-IV, hemoglobin level <120 g/L, elevated LDH and >4 nodal sites. The following table summarizes the results of analyzing 1,647 patients with follicular lymphoma:

The remaining 4 variables were predictive when data was analyzed for those under or over 60 years of age. A prospective group of 919 patients was analyzed using the same prognostic index. The low-risk group had a 5-year survival of approximately 90%, the intermediate-risk group an approximate 5-survival of 78% and the high-risk group had a 5-year survival of 50%.

Comments: This new international prognostic index for follicular lymphoma should facilitate the stratification of patients for entry on clinical trials. It would appear from these results that good-risk patients would benefit little from up-front aggressive therapy.

Reference: Solal-Celigny P, Roy P, Colombat P, et al. Follicular Lymphoma International Prognostic Index. Blood. 2004;104:1258-1265.