Enciso Leonardo, González Farley Johanna, Pérez Luz E, Ramos Ana María, Samacá-Samacá Daniel, Badillo Carlos
Hemato-Oncology Division, Clinical Research Unit, Centro de Biociencias SURA, Medellín, Colombia.
Clinical Research Unit, Centro de Biociencias SURA, Medellín, Colombia.
Ann Hematol. 2025 Apr;104(4):2327-2336. doi: 10.1007/s00277-025-06341-x. Epub 2025 Apr 14.
Follicular lymphoma (FL) is the second most common mature B lymphoid neoplasm. Understanding its epidemiology and clinical features is crucial for developing healthcare strategies, especially in low-and middle-income countries. This retrospective study analyzed clinical features, treatment patterns and outcomes of FL patients in a Colombian Health Maintenance Organization from 2018 to 2023. Statistical analyses were descriptive; survival was assessed using the Kaplan-Meier method. A total of 406 patients were included (mean age: 55.7 ± 13.8 years; 59.4% women). 79% of patients were classified as Ann Arbor stage III-IV, and 35% as high-risk in the FLIPI score. Most frequent first line (1 L) treatments were R-CHOP (63.5%) and R-CVP (10.8%), with 77.3% of patients achieving complete response (CR). Progression to second line (2L) therapy occurred in 30% of patients; 82% achieved CR. Most frequent 2L treatments were radiotherapy (23%), obinutuzumab-based regimens (18%) and R-Bendamustine (18%). Five-year progression-free survival was 70.4%, and overall survival at 5 and 10 years was 92% and 85%, respectively. A lower risk of death was observed in patients with low-intermediate FLIPI compared to patients with high FLIPI (HR = 0.23; 95%CI: 0.11-0.49). Patients with progression in the first 24 months (POD24) had a higher risk of mortality (HR = 6.54; 95%CI = 2.73-15.43). We report an approximation of the current status of FL in Colombia. Findings showed high response rates to initial treatment and prolonged overall survival. The presence of a high FLIPI score and POD24 were associated with an increased risk of mortality.
滤泡性淋巴瘤（FL）是第二常见的成熟B淋巴细胞肿瘤。了解其流行病学和临床特征对于制定医疗保健策略至关重要，尤其是在低收入和中等收入国家。这项回顾性研究分析了2018年至2023年哥伦比亚一家健康维护组织中FL患者的临床特征、治疗模式和结局。统计分析为描述性分析；使用Kaplan-Meier方法评估生存率。共纳入406例患者（平均年龄：55.7±13.8岁；59.4%为女性）。79%的患者被分类为Ann Arbor III-IV期，35%的患者在滤泡性淋巴瘤国际预后指数（FLIPI）评分中为高危。最常见的一线（1L）治疗方案是利妥昔单抗联合环磷酰胺、阿霉素、长春新碱和泼尼松（R-CHOP，63.5%）和利妥昔单抗联合环磷酰胺、长春新碱和泼尼松（R-CVP，10.8%），77.3%的患者达到完全缓解（CR）。30%的患者进展至二线（2L）治疗；82%的患者达到CR。最常见的2L治疗方案是放疗（23%）、基于奥妥珠单抗的方案（18%）和利妥昔单抗联合苯达莫司汀（R-Bendamustine，18%）。五年无进展生存率为70.4%，5年和10年总生存率分别为92%和85%。与FLIPI高的患者相比，FLIPI低-中度的患者死亡风险较低（风险比[HR]=0.23；95%置信区间[CI]：0.11-0.49）。在最初24个月内出现疾病进展（POD24）的患者死亡风险较高（HR=6.54；95%CI=2.73-15.43）。我们报告了哥伦比亚FL的当前状况。研究结果显示初始治疗的缓解率高且总生存期延长。FLIPI评分高和POD24与死亡风险增加相关。
