Su Yang, Hu Qi, Zhao Weili, Liu Chi, Wang Li, Cheng Shu, Xu Pengpeng, Liu Linlin, Yang Wenzhong
Department of Hematology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China.
Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Ann Hematol. 2025 Sep 20. doi: 10.1007/s00277-025-06617-2.
Follicular lymphoma (FL) is a common indolent B-cell lymphoma with heterogeneous clinical behavior. Prognostic data from Chinese real-world populations remain Limited. We retrospectively analyzed 118 patients with newly diagnosed FL treated at our center from January 2022 to December 2024. Clinical features, laboratory indicators, immune markers, and treatment responses were evaluated. Survival outcomes were analyzed using Kaplan-Meier and Cox regression methods. The follow-up ended on January 31, 2025, with a median follow-up duration of 11.2 months (range, 1.1-36.0 months). The 2-year overall survival (OS) and progression-free survival (PFS) rates were 90.1% and 69.7%, respectively. The overall complete response (CR) rate was 60.2%. In univariate analysis, several factors including pathological grade 3B/composite histology, B symptoms, low NK cell percentage (< 8%), low CD4 T cell levels (< 30%), CD5 positivity, CD10 negativity, and MUM1 positivity were significantly associated with poor OS and/or PFS. Multivariate Cox regression revealed that pathological grade 3B/composite histology was an independent risk factor for PFS (HR 2.933, P = 0.035), while NK cell percentage < 8% independently predicted worse OS (HR 0.067, P = 0.005). This study validates the prognostic significance of pathological grade and NK cell levels in a Chinese real-world FL population. Peripheral blood NK cell percentage may serve as a clinically useful biomarker for host immune status and prognosis. The findings support further investigation into immune-based prognostic markers and therapeutic strategies in FL.
滤泡性淋巴瘤（FL）是一种常见的惰性B细胞淋巴瘤，具有异质性的临床行为。来自中国真实世界人群的预后数据仍然有限。我们回顾性分析了2022年1月至2024年12月在本中心接受治疗的118例新诊断FL患者。评估了临床特征、实验室指标、免疫标志物和治疗反应。使用Kaplan-Meier和Cox回归方法分析生存结果。随访于2025年1月31日结束，中位随访时间为11.2个月（范围1.1 - 36.0个月）。2年总生存率（OS）和无进展生存率（PFS）分别为90.1%和69.7%。总体完全缓解（CR）率为60.2%。单因素分析中，包括病理3B级/复合组织学、B症状、低NK细胞百分比（<8%）、低CD4 T细胞水平（<30%）、CD5阳性、CD10阴性和MUM1阳性等几个因素与较差的OS和/或PFS显著相关。多因素Cox回归显示，病理3B级/复合组织学是PFS的独立危险因素（HR 2.933，P = 0.035），而NK细胞百分比<8%独立预测较差的OS（HR 0.067，P = 0.005）。本研究验证了在中国真实世界FL人群中病理分级和NK细胞水平的预后意义。外周血NK细胞百分比可能作为宿主免疫状态和预后的临床有用生物标志物。这些发现支持对FL中基于免疫的预后标志物和治疗策略进行进一步研究。
