Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2023; 11(14): 3176-3186
Published online May 16, 2023. doi: 10.12998/wjcc.v11.i14.3176
Clinical features and prognostic factors in 49 patients with follicular lymphoma at a single center: A retrospective analysis
Hao Wu, Hui-Cong Sun, Gui-Fang Ouyang
Hao Wu, Gui-Fang Ouyang, Department of Hematology, Ningbo First Hospital, Ningbo 315010, Zhejiang Province, China
Hui-Cong Sun, Adult Internal Medicine, Ningbo Women and Children's Hospital, Ningbo 315012, Zhejiang Province, China
Author contributions: Ouyang GF provided the experimental idea; Wu H and Sun HC collected, sorted, and analyzed the data; Wu H completed the writing of this article; and all authors have read and approved the final draft.
Supported by Zhejiang TCM Science and Technology Project, No. 2023ZL653.
Institutional review board statement: This study was approved by the Institutional Ethics Committee of Ningbo First Hospital.
Informed consent statement: Informed consent was obtained from the patients and their parents/guardians.
Conflict-of-interest statement: We have no financial relationships or any other conflict of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gui-Fang Ouyang, MD, Chief Physician, Department of Hematology, Ningbo First Hospital, No. 59 Liuting Street, Ningbo 315010, Zhejiang Province, China. oyguifangoy@163.com
Received: February 27, 2023
Peer-review started: February 27, 2023
First decision: March 10, 2023
Revised: March 24, 2023
Accepted: April 12, 2023
Article in press: April 12, 2023
Published online: May 16, 2023
Abstract
BACKGROUND

Follicular lymphoma (FL) is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate. FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.

AIM

To explore the clinical features, curative effects, and prognostic factors of FL.

METHODS

Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined. These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining. The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas. Ann Arbor staging was performed according to the imaging and bone marrow examination results. Risk stratification of all patients was performed based on the International Prognostic Index (IPI), age-adjusted IPI, Follicular Lymphoma International Prognosis Index (FLIPI), and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.

RESULTS

The age of onset in patients ranged from 24 to 76 years, with a median age of 51 years. Most patients developed the disease at 40–59 years of age, and the male:female ratio was 1.6:1. No significant difference was noted in the curative effect between the non-chemotherapy, combined chemotherapy, and other chemotherapy regimens (P > 0.05). Hemoglobin (Hb) level < 120 g/L, Ki-67 value > 50%, bone marrow involvement, and clinical stages III–IV were associated with a poor prognosis of FL (P < 0.05). However, the influence of other indicators was not statistically significant. Risk grouping was performed using the FLIPI, and the results showed that 24.5%, 40.8%, and 34.7% of patients were in the low-, moderate-, and high-risk groups, respectively. According to the survival analysis results, the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups (P < 0.05).

CONCLUSION

FL mainly occurs in middle-aged and elderly men, primarily affecting lymph nodes and bone marrow. Hb level, Ki-67 value, bone marrow involvement, and clinical staging were used to evaluate prognosis.

Keywords: Follicular lymphoma, Clinical feature, Curative effect, Prognosis, Survival analysis, Follicular Lymphoma International Prognosis Index

Core Tip: Follicular lymphoma (FL) is a B-cell lymphoma originating from the germinal center and has a low malignancy rate. Completed medical records of 49 patients with follicular lymphoma admitted from June 2010 to June 2021 were retrospectively reviewed. FL was more common in middle-aged and elderly men than in women, mainly involving the lymph nodes and bone marrow. However, an optimal treatment strategy remains unclear. Hemoglobin levels, Ki-67 values, bone marrow involvement, and clinical stage can be used to evaluate prognosis.