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. 2020 Jan;188(2):259-267.
doi: 10.1111/bjh.16159. Epub 2019 Aug 18.

M7-FLIPI is not prognostic in follicular lymphoma patients with first-line rituximab chemo-free therapy

Sandra Lockmer  1   2 , Weicheng Ren  3 , Marianne Brodtkorb  4 , Bjørn Østenstad  4 , Björn E Wahlin  1   2 , Qiang Pan-Hammarström  3 , Eva Kimby  1
Affiliations

M7-FLIPI is not prognostic in follicular lymphoma patients with first-line rituximab chemo-free therapy

Sandra Lockmer et al. Br J Haematol. 2020 Jan.

Abstract

The clinical course of follicular lymphoma (FL) is highly variable. Recently the m7-FL international prognostic index (FLIPI) integrating performance status, FLIPI score and the mutational status of seven genes, was shown to stratify patients into "low-risk" and "high-risk" with respect to 5-year failure-free survival after first-line immunochemotherapy. Our aim was to evaluate the model after rituximab without chemotherapy. The Nordic Lymphoma Group performed two randomized clinical trials on indolent lymphoma patients receiving single rituximab and rituximab with interferon-α2a. In total, 95 FL patients had sufficient fresh-frozen diagnostic material for sequencing. A targeted panel for the genes EZH2, ARID1A, MEF2B, EP300, FOXO1, CREBBP and CARD11 was utilized for m7-FLIPI score calculation. With a median follow-up of 10·6 years, 76% of patients were alive. No difference in time to treatment failure (TTF), defined as the interval between start of trial therapy and initiation of new therapy or death, nor overall survival (OS) was found between the m7-FLIPI risk groups (log-rank P = 0·94 and 0·99, respectively). EZH2 mutations were associated with longer TTF (log-rank P = 0·04) and in EP300 mutations were associated with shorter TTF (log-rank P = 0·01). We conclude that the prognostic value of the m7-FLIPI clinicogenetic model seems dependent on therapeutic regimen.

Keywords: chemotherapy-free; follicular lymphoma; gene sequencing; m7-FLIPI; rituximab.

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References

    1. Ardeshna, K.M., Qian, W., Smith, P., Braganca, N., Lowry, L., Patrick, P., Warden, J., Stevens, L., Pocock, C.F., Miall, F., Cunningham, D., Davies, J., Jack, A., Stephens, R., Walewski, J., Ferhanoglu, B., Bradstock, K. & Linch, D.C. (2014) Rituximab versus a watch-and-wait approach in patients with advanced-stage, asymptomatic, non-bulky follicular lymphoma: an open-label randomised phase 3 trial. The Lancet Oncology, 15, 424-35.
    1. Bachy, E., Maurer, M.J., Habermann, T.M., Gelas-Dore, B., Maucort-Boulch, D., Estell, J.A., Van den Neste, E., Bouabdallah, R., Gyan, E., Feldman, A.L., Bargay, J., Delmer, A., Slager, S.L., Gomes da Silva, M., Fitoussi, O., Belada, D., Maisonneuve, H., Intragumtornchai, T., Ansell, S.M., Lamy, T., Dartigues, P., Link, B.K., Seymour, J.F., Cerhan, J.R. & Salles, G. (2018) A simplified scoring system in de novo follicular lymphoma treated initially with immunochemotherapy. Blood, 132, 49-58.
    1. Casulo, C., Byrtek, M., Dawson, K.L., Zhou, X., Farber, C.M., Flowers, C.R., Hainsworth, J.D., Maurer, M.J., Cerhan, J.R., Link, B.K., Zelenetz, A.D. & Friedberg, J.W. (2015) Early Relapse of Follicular Lymphoma After Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone Defines Patients at High Risk for Death: An Analysis From the National LymphoCare Study. Journal of Clinical Oncology, 33, 2516-2522.
    1. Colombat, P., Brousse, N., Salles, G., Morschhauser, F., Brice, P., Soubeyran, P., Delwail, V., Deconinck, E., Haioun, C., Foussard, C., Sebban, C., Tilly, H., Thieblemont, C., Bergougnoux, L., Lazreg, F. & Solal-Céligny, P. (2012) Rituximab induction immunotherapy for first-line low-tumor-burden follicular lymphoma: survival analyses with 7-year follow-up. Annals of Oncology, 23, 2380-2385.
    1. Drabløs, F., Feyzi, E., Aas, P.A., Vaagbø, C.B., Kavli, B., Bratlie, M.S., Peña-Diaz, J., Otterlei, M., Slupphaug, G. & Krokan, H.E. (2004) Alkylation damage in DNA and RNA-repair mechanisms and medical significance. DNA Repair, 3, 1389-1407.

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