A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy

Emmanuel Bachy, Matthew J. Maurer, Thomas Matthew Habermann, Bénédicte Gelas-Dore, Delphine Maucort-Boulch, Jane A. Estell, Eric Van den Neste, Réda Bouabdallah, Emmanuel Gyan, Andrew L Feldman, Joan Bargay, Alain Delmer, Susan L Slager, Maria Gomes da Silva, Olivier Fitoussi, David Belada, Hervé Maisonneuve, Tanin Intragumtornchai, Stephen Maxted Ansell, Thierry Lamy & 5 others Peggy Dartigues, Brian K. Link, John F. Seymour, James R Cerhan, Gilles Salles

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

In follicular lymphoma (FL), no prognostic index has been built based solely on a cohort of patients treated with initial immunochemotherapy. There is currently a need to define parsimonious clinical models for trial stratification and to add on biomolecular factors. Here, we confirmed the validity of both the follicular lymphoma international prognostic index (FLIPI) and the FLIPI2 in the large prospective PRIMA trial cohort of 1135 patients treated with initial R-chemotherapy 6 R maintenance. Furthermore, we developed a new prognostic tool comprising only 2 simple parameters (bone marrow involvement and b2-microglobulin [b2m]) to predict progression-free survival (PFS). The final simplified score, called the PRIMA-PI (PRIMA-prognostic index), comprised 3 risk categories: high (b2m > 3 mg/L), low (b2m £ 3 mg/L without bone marrow involvement), and intermediate (b2m £ 3 mg/L with bone marrow involvement). Five-year PFS rates were 69%, 55%, and 37% in the low-, intermediate-, and high-risk groups, respectively (P < .0001). In addition, achieving event-free survival (EFS) or not at 24 months (EFS24) was a strong posttreatment prognostic parameter for subsequent overall survival, and the PRIMA-PI was correlated with EFS24. The results were confirmed in a pooled external validation cohort of 479 patients from the FL2000 LYSA trial and the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource. Five-year EFS in the validation cohort was 77%, 57%, and 44% in the PRIMA-PI low-, intermediate-, and high-risk groups, respectively (P < .0001). The PRIMA-PI is a novel and easy-to-compute prognostic index for patients initially treated with immunochemotherapy. This could serve as a basis for building more sophisticated and integrated biomolecular scores.

Original languageEnglish (US)
Pages (from-to)49-58
Number of pages10
JournalBlood
Volume132
Issue number1
DOIs
StatePublished - Jul 5 2018

Fingerprint

Follicular Lymphoma
Disease-Free Survival
Bone
Bone Marrow
Chemotherapy
Molecular Epidemiology
Lymphoma
Survival Rate
Maintenance
Clinical Trials
Drug Therapy
Survival
Research

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Bachy, E., Maurer, M. J., Habermann, T. M., Gelas-Dore, B., Maucort-Boulch, D., Estell, J. A., ... Salles, G. (2018). A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy. Blood, 132(1), 49-58. https://doi.org/10.1182/blood-2017-11-816405

A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy. / Bachy, Emmanuel; Maurer, Matthew J.; Habermann, Thomas Matthew; Gelas-Dore, Bénédicte; Maucort-Boulch, Delphine; Estell, Jane A.; Van den Neste, Eric; Bouabdallah, Réda; Gyan, Emmanuel; Feldman, Andrew L; Bargay, Joan; Delmer, Alain; Slager, Susan L; da Silva, Maria Gomes; Fitoussi, Olivier; Belada, David; Maisonneuve, Hervé; Intragumtornchai, Tanin; Ansell, Stephen Maxted; Lamy, Thierry; Dartigues, Peggy; Link, Brian K.; Seymour, John F.; Cerhan, James R; Salles, Gilles.

In: Blood, Vol. 132, No. 1, 05.07.2018, p. 49-58.

Research output: Contribution to journalArticle

Bachy, E, Maurer, MJ, Habermann, TM, Gelas-Dore, B, Maucort-Boulch, D, Estell, JA, Van den Neste, E, Bouabdallah, R, Gyan, E, Feldman, AL, Bargay, J, Delmer, A, Slager, SL, da Silva, MG, Fitoussi, O, Belada, D, Maisonneuve, H, Intragumtornchai, T, Ansell, SM, Lamy, T, Dartigues, P, Link, BK, Seymour, JF, Cerhan, JR & Salles, G 2018, 'A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy', Blood, vol. 132, no. 1, pp. 49-58. https://doi.org/10.1182/blood-2017-11-816405
Bachy, Emmanuel ; Maurer, Matthew J. ; Habermann, Thomas Matthew ; Gelas-Dore, Bénédicte ; Maucort-Boulch, Delphine ; Estell, Jane A. ; Van den Neste, Eric ; Bouabdallah, Réda ; Gyan, Emmanuel ; Feldman, Andrew L ; Bargay, Joan ; Delmer, Alain ; Slager, Susan L ; da Silva, Maria Gomes ; Fitoussi, Olivier ; Belada, David ; Maisonneuve, Hervé ; Intragumtornchai, Tanin ; Ansell, Stephen Maxted ; Lamy, Thierry ; Dartigues, Peggy ; Link, Brian K. ; Seymour, John F. ; Cerhan, James R ; Salles, Gilles. / A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy. In: Blood. 2018 ; Vol. 132, No. 1. pp. 49-58.
@article{c9cbe9a408d2471498999eaddc0f2f0f,
title = "A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy",
abstract = "In follicular lymphoma (FL), no prognostic index has been built based solely on a cohort of patients treated with initial immunochemotherapy. There is currently a need to define parsimonious clinical models for trial stratification and to add on biomolecular factors. Here, we confirmed the validity of both the follicular lymphoma international prognostic index (FLIPI) and the FLIPI2 in the large prospective PRIMA trial cohort of 1135 patients treated with initial R-chemotherapy 6 R maintenance. Furthermore, we developed a new prognostic tool comprising only 2 simple parameters (bone marrow involvement and b2-microglobulin [b2m]) to predict progression-free survival (PFS). The final simplified score, called the PRIMA-PI (PRIMA-prognostic index), comprised 3 risk categories: high (b2m > 3 mg/L), low (b2m £ 3 mg/L without bone marrow involvement), and intermediate (b2m £ 3 mg/L with bone marrow involvement). Five-year PFS rates were 69{\%}, 55{\%}, and 37{\%} in the low-, intermediate-, and high-risk groups, respectively (P < .0001). In addition, achieving event-free survival (EFS) or not at 24 months (EFS24) was a strong posttreatment prognostic parameter for subsequent overall survival, and the PRIMA-PI was correlated with EFS24. The results were confirmed in a pooled external validation cohort of 479 patients from the FL2000 LYSA trial and the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource. Five-year EFS in the validation cohort was 77{\%}, 57{\%}, and 44{\%} in the PRIMA-PI low-, intermediate-, and high-risk groups, respectively (P < .0001). The PRIMA-PI is a novel and easy-to-compute prognostic index for patients initially treated with immunochemotherapy. This could serve as a basis for building more sophisticated and integrated biomolecular scores.",
author = "Emmanuel Bachy and Maurer, {Matthew J.} and Habermann, {Thomas Matthew} and B{\'e}n{\'e}dicte Gelas-Dore and Delphine Maucort-Boulch and Estell, {Jane A.} and {Van den Neste}, Eric and R{\'e}da Bouabdallah and Emmanuel Gyan and Feldman, {Andrew L} and Joan Bargay and Alain Delmer and Slager, {Susan L} and {da Silva}, {Maria Gomes} and Olivier Fitoussi and David Belada and Herv{\'e} Maisonneuve and Tanin Intragumtornchai and Ansell, {Stephen Maxted} and Thierry Lamy and Peggy Dartigues and Link, {Brian K.} and Seymour, {John F.} and Cerhan, {James R} and Gilles Salles",
year = "2018",
month = "7",
day = "5",
doi = "10.1182/blood-2017-11-816405",
language = "English (US)",
volume = "132",
pages = "49--58",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "1",

}

TY - JOUR

T1 - A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy

AU - Bachy, Emmanuel

AU - Maurer, Matthew J.

AU - Habermann, Thomas Matthew

AU - Gelas-Dore, Bénédicte

AU - Maucort-Boulch, Delphine

AU - Estell, Jane A.

AU - Van den Neste, Eric

AU - Bouabdallah, Réda

AU - Gyan, Emmanuel

AU - Feldman, Andrew L

AU - Bargay, Joan

AU - Delmer, Alain

AU - Slager, Susan L

AU - da Silva, Maria Gomes

AU - Fitoussi, Olivier

AU - Belada, David

AU - Maisonneuve, Hervé

AU - Intragumtornchai, Tanin

AU - Ansell, Stephen Maxted

AU - Lamy, Thierry

AU - Dartigues, Peggy

AU - Link, Brian K.

AU - Seymour, John F.

AU - Cerhan, James R

AU - Salles, Gilles

PY - 2018/7/5

Y1 - 2018/7/5

N2 - In follicular lymphoma (FL), no prognostic index has been built based solely on a cohort of patients treated with initial immunochemotherapy. There is currently a need to define parsimonious clinical models for trial stratification and to add on biomolecular factors. Here, we confirmed the validity of both the follicular lymphoma international prognostic index (FLIPI) and the FLIPI2 in the large prospective PRIMA trial cohort of 1135 patients treated with initial R-chemotherapy 6 R maintenance. Furthermore, we developed a new prognostic tool comprising only 2 simple parameters (bone marrow involvement and b2-microglobulin [b2m]) to predict progression-free survival (PFS). The final simplified score, called the PRIMA-PI (PRIMA-prognostic index), comprised 3 risk categories: high (b2m > 3 mg/L), low (b2m £ 3 mg/L without bone marrow involvement), and intermediate (b2m £ 3 mg/L with bone marrow involvement). Five-year PFS rates were 69%, 55%, and 37% in the low-, intermediate-, and high-risk groups, respectively (P < .0001). In addition, achieving event-free survival (EFS) or not at 24 months (EFS24) was a strong posttreatment prognostic parameter for subsequent overall survival, and the PRIMA-PI was correlated with EFS24. The results were confirmed in a pooled external validation cohort of 479 patients from the FL2000 LYSA trial and the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource. Five-year EFS in the validation cohort was 77%, 57%, and 44% in the PRIMA-PI low-, intermediate-, and high-risk groups, respectively (P < .0001). The PRIMA-PI is a novel and easy-to-compute prognostic index for patients initially treated with immunochemotherapy. This could serve as a basis for building more sophisticated and integrated biomolecular scores.

AB - In follicular lymphoma (FL), no prognostic index has been built based solely on a cohort of patients treated with initial immunochemotherapy. There is currently a need to define parsimonious clinical models for trial stratification and to add on biomolecular factors. Here, we confirmed the validity of both the follicular lymphoma international prognostic index (FLIPI) and the FLIPI2 in the large prospective PRIMA trial cohort of 1135 patients treated with initial R-chemotherapy 6 R maintenance. Furthermore, we developed a new prognostic tool comprising only 2 simple parameters (bone marrow involvement and b2-microglobulin [b2m]) to predict progression-free survival (PFS). The final simplified score, called the PRIMA-PI (PRIMA-prognostic index), comprised 3 risk categories: high (b2m > 3 mg/L), low (b2m £ 3 mg/L without bone marrow involvement), and intermediate (b2m £ 3 mg/L with bone marrow involvement). Five-year PFS rates were 69%, 55%, and 37% in the low-, intermediate-, and high-risk groups, respectively (P < .0001). In addition, achieving event-free survival (EFS) or not at 24 months (EFS24) was a strong posttreatment prognostic parameter for subsequent overall survival, and the PRIMA-PI was correlated with EFS24. The results were confirmed in a pooled external validation cohort of 479 patients from the FL2000 LYSA trial and the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence Molecular Epidemiology Resource. Five-year EFS in the validation cohort was 77%, 57%, and 44% in the PRIMA-PI low-, intermediate-, and high-risk groups, respectively (P < .0001). The PRIMA-PI is a novel and easy-to-compute prognostic index for patients initially treated with immunochemotherapy. This could serve as a basis for building more sophisticated and integrated biomolecular scores.

UR - http://www.scopus.com/inward/record.url?scp=85049583944&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049583944&partnerID=8YFLogxK

U2 - 10.1182/blood-2017-11-816405

DO - 10.1182/blood-2017-11-816405

M3 - Article

VL - 132

SP - 49

EP - 58

JO - Blood

JF - Blood

SN - 0006-4971

IS - 1

ER -