Wu Hao, Sun Hui-Cong, Ouyang Gui-Fang
Department of Hematology, Ningbo First Hospital, Ningbo 315010, Zhejiang Province, China.
Adult Internal Medicine, Ningbo Women and Children's Hospital, Ningbo 315012, Zhejiang Province, China.
World J Clin Cases. 2023 May 16;11(14):3176-3186. doi: 10.12998/wjcc.v11.i14.3176.
Follicular lymphoma (FL) is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate. FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.
To explore the clinical features, curative effects, and prognostic factors of FL.
Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined. These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining. The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas. Ann Arbor staging was performed according to the imaging and bone marrow examination results. Risk stratification of all patients was performed based on the International Prognostic Index (IPI), age-adjusted IPI, Follicular Lymphoma International Prognosis Index (FLIPI), and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.
The age of onset in patients ranged from 24 to 76 years, with a median age of 51 years. Most patients developed the disease at 40-59 years of age, and the male:female ratio was 1.6:1. No significant difference was noted in the curative effect between the non-chemotherapy, combined chemotherapy, and other chemotherapy regimens ( > 0.05). Hemoglobin (Hb) level < 120 g/L, Ki-67 value > 50%, bone marrow involvement, and clinical stages III-IV were associated with a poor prognosis of FL ( < 0.05). However, the influence of other indicators was not statistically significant. Risk grouping was performed using the FLIPI, and the results showed that 24.5%, 40.8%, and 34.7% of patients were in the low-, moderate-, and high-risk groups, respectively. According to the survival analysis results, the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups ( < 0.05).
FL mainly occurs in middle-aged and elderly men, primarily affecting lymph nodes and bone marrow. Hb level, Ki-67 value, bone marrow involvement, and clinical staging were used to evaluate prognosis.
滤泡性淋巴瘤(FL)是一种起源于生发中心的B细胞淋巴瘤,恶性率较低。FL已成为欧美最常见的惰性淋巴瘤,但在亚洲发病率相对较低。
探讨FL的临床特征、疗效及预后因素。
查阅2010年6月至2021年6月期间宁波第一医院收治的49例FL患者的完整病历。这些患者通过病理活检或免疫组化染色明确诊断。诊断标准依据2008年世界卫生组织淋巴瘤分类。根据影像学和骨髓检查结果进行Ann Arbor分期。基于国际预后指数(IPI)、年龄调整后的IPI、滤泡性淋巴瘤国际预后指数(FLIPI)和FLIPI2对所有患者进行风险分层,以比较不同治疗方案的疗效并分析相关预后因素。
患者发病年龄为24至76岁,中位年龄为51岁。大多数患者在40至59岁发病,男女比例为1.6:1。非化疗、联合化疗和其他化疗方案之间的疗效无显著差异(>0.05)。血红蛋白(Hb)水平<120 g/L、Ki-67值>50%、骨髓受累及临床分期III-IV与FL预后不良相关(<0.05)。然而,其他指标的影响无统计学意义。采用FLIPI进行风险分组,结果显示24.5%、40.8%和34.7%的患者分别处于低、中、高风险组。根据生存分析结果,高风险组患者的生存率低于其他低风险和中风险组(<0.05)。
FL主要发生于中老年男性,主要累及淋巴结和骨髓。Hb水平、Ki-67值、骨髓受累及临床分期用于评估预后。