A review of Barts follicular data on 387 patients diagnosed from Jan 1st 1968 to Dec 31st 1999 (32 years).
Sharon Love with Andrew Davies, Silvia Montoto, Janet Matthews, Andrew Lister (London)
Follicular lymphoma is an indolent B cell lymphoma. Patients often present at an advanced stage (i.e. with bone marrow involvement) and with lymph node involvement. Most patients need treatment within 13 months of diagnosis, and the majority will respond (70-80%). This is unlikely to be a cure and most patients will relapse. The response rate up to and including the third treatment is still around 70-80%, but thereafter the response rate drops and it is more difficult to find a suitable treatment.
The Follicular Lymphoma International Prognostic Index (FLIPI) was published in Blood in May 2004. It was created from 1795 patients (including 100 from Barts) and validated externally on a further 1000. The FLIPI is the factors prognostic for survival from the time of diagnosis.
Age (<60, >=60)
Ann Arbor stage (I,II or III,IV)
Haemoglobin level ( >=12 or <12)
Number of nodal areas involved ( <=4 or >4)
Serum LDH (,=normal or >normal)
The patients are then divided into three risk groups
0 or 1 poor factors
2 poor factors
3,4 or 5 poor factors
Barts have 32 years of lymphoma patient accrual with data collected at each relapse. We want to see if we can validate the FLIPI as a prognostic index that can also be used at relapse and also to use a repeated event Cox model to investigate the repeated relapses. We reach the end of 2004 with 90% of the data checked, including follow-up and the analysis due to begin in Feb 2005.