Life expectancy of young adults with follicular lymphoma
Menées à partir de données portant sur 2 652 patients américains et 155 patients européens atteints d'un lymphome folliculaire avant 40 ans, ces études analysent les caractéristiques de la maladie, les traitements et la survie des patients
Background : This study was aimed at investigating the clinical features and outcome of follicular lymphoma (FL) patients younger than 40 years, which have not been extensively investigated yet.
Patients and methods :One hundred and fifty-five patients younger than 40 years were retrospectively studied from a series of 1002 FL patients diagnosed in four different European Oncology Centres (Barcelona, Spain; Bellinzona, Switzerland; London, United Kingdom; Novara, Italy) from 1985 to 2010.
Results : Patients younger than 40 had a lower incidence of elevated LDH, high beta2-microglobulin and high risk Follicular Lymphoma International Prognostic Index (FLIPI) score, whereas bone marrow involvement, bulky and disseminated lymphadenopathy were more frequent. At a median follow-up of 10 years, younger patients, in comparison with those older than 40, had significantly better overall (OS), cause specific survival (CSS) and progression free survival (PFS), with 10-year OS rate of 81% vs 51% (P<0.0001), 10-year CSS rate of 82% vs 60%, (P<0.0001) and 10-year PFS of 39% vs 24% (P=0.0098). However, there were no significant CSS and PFS differences in comparison with the patients aged 40 to 60. In multivariate analysis, having the lymphoma diagnosed in the last two decades and a favourable FLIPI score were associated with a significantly longer PFS and CSS in younger patients, while only FLIPI retained statistical significance for OS.
Conclusions : In our series, FL patients younger than 40 have a median OS of 24 years and their outcome seems to be improving over time. However, they still have a significantly shorter life expectancy than that of an age-matched general healthy population
Annals of Oncology , résumé, 2014