Differences in clinical characteristics and outcomes between patients with grade 3a and grades 1–2 follicular lymphoma: a real-world multicenter study

作者：Jie Zha, Qinwei Chen, Jingjing Ye, Haifeng Yu, Shuhua Yi, Zhong Zheng, Wei Xu, Zhifeng Li, Zhifeng Li, Lingyan Ping, Xiaohua He, Liling Zhang, Caixia Li, Ying Xie, Feili Chen, Xiuhua Sun, Liping Su, Huilai Zhang, Liyuan Fan, Zhijuan Lin, Haiyan Yang, Weili Zhao, Lugui Qiu, Zhiming Li, Zhiming Li, Yuqin Song, Bing Xu · 发表于：Biomarker Research · 年份：2023 · DOI：10.1186/s40364-023-00462-z · 被引用次数：14 · 研究领域：Lymphoma Diagnosis and Treatment、Cutaneous lymphoproliferative disorders research、Chronic Lymphocytic Leukemia Research

BACKGROUND: The difference between clinical characteristics and outcomes between follicular lymphoma grade 1-2 (FL1-2) and FL3a defined pathologically remains unclear, resulting in uncertainty how to treat FL3a. However, it may be crucial for clinicians to discriminate grade 3a and grade 1-2 for predicting prognosis and thus making treatment decisions. METHODS: We compared 1403 patients with FL1-2 and 765 patients with FL3a diagnosed between January 2000 and December 2020 from fifteen centers nationwide in China to describe differences in clinical characteristics and outcomes. RESULTS: Compared with FL1-2 patients, FL3a subgroup had a higher percentage of elderly patients (P = 0.003), and relatively more FL3a patients presented with increased levels of LDH (P < 0.0001) and higher Ki-67 indexs greater than 30% (P < 0.001). More FL3a patients were treated with CHOP ± R (P < 0.0001), and fewer were treated with the watchful-waiting approach (P < 0.0001). The results showed a higher incidence of relapse among FL3a patients, in which more patients underwent histological transformation (HT) when compared to FL1-2 (P = 0.003). 1470 (76.2%) patients of the entire cohort received R-CHOP therapy; survival analysis revealed that FL3a patients had a worse progression-free survival (PFS) rate than FL1-2 patients. Survival of FL3a patients with respect to FLIPI showed an inferior PFS in the intermediate and high-risk groups than FL1-2 patients. FL3a patients had a much worse prognosis than...