Hori Yoshikazu, Hosoi Hiroki, Hiroi Takayuki, Wan Ke, Murata Shogo, Morimoto Masaya, Mushino Toshiki, Nishikawa Akinori, Sonoki Takashi
Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan.
Department of Hematology, Kinan Hospital, Wakayama 646-8588, Japan.
Hematol Rep. 2024 Oct 4;16(4):612-623. doi: 10.3390/hematolrep16040060.
Although the prognosis of follicular lymphoma (FL) has improved, some patients experience early disease progression, including progression of disease within 24 months (POD24). Histological transformation is a critical event in FL. However, the heterogeneity of FL tumors makes it challenging to diagnose transformation accurately. We retrospectively applied the clinical transformation criteria used for FL transformation assessments at relapse or disease progression to conduct transformation assessments before the initial immunochemotherapy.
Sixty-six FL patients who first received immunochemotherapy between January 2009 and February 2023 at our institution were selected. Twenty-three were clinical-transformation-positive (CLT+).
The progression-free survival (PFS) rate of the CLT+ patients was significantly lower than that of the clinical-transformation-negative (CLT-) patients. In the POD24 assessment subgroup, the CLT+ patients had a higher incidence of POD24 than the CLT- patients. There was no significant difference in PFS between the patients treated with CHOP-like regimens and those treated with bendamustine regimens. In the CHOP-like group, the CLT+ patients exhibited significantly lower PFS than the CLT- patients. In the bendamustine group, the clinical transformation did not affect PFS.
Clinical transformation criteria may be useful for the prognostic stratification of FL prior to immunochemotherapy. Additionally, they may serve as predictors of POD24.
尽管滤泡性淋巴瘤（FL）的预后有所改善，但一些患者会出现疾病早期进展，包括在24个月内疾病进展（POD24）。组织学转化是FL中的一个关键事件。然而，FL肿瘤的异质性使得准确诊断转化具有挑战性。我们回顾性应用用于复发或疾病进展时FL转化评估的临床转化标准，在初始免疫化疗前进行转化评估。
选择2009年1月至2023年2月在我院首次接受免疫化疗的66例FL患者。23例为临床转化阳性（CLT+）。
CLT+患者的无进展生存期（PFS）率显著低于临床转化阴性（CLT-）患者。在POD24评估亚组中，CLT+患者的POD24发生率高于CLT-患者。接受CHOP样方案治疗的患者与接受苯达莫司汀方案治疗的患者的PFS无显著差异。在CHOP样组中，CLT+患者的PFS显著低于CLT-患者。在苯达莫司汀组中，临床转化不影响PFS。
临床转化标准可能有助于FL免疫化疗前的预后分层。此外，它们可能作为POD24的预测指标。
