The age-adjusted international prognostic index 2 (A-FLIPI2) for elderly patients with follicular lymphoma
Follicular lymphoma (FL) is a common B-cell lymphoma and typically affects the elderly population. It is urgently required to enhance our comprehension of disease-specific outcomes in elderly FL patients and identify a reliable predictive indicator to assess patient risk and guide treatment options...
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Elsevier
2025-02-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844025008771 |
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| author | Jiesong Wang Junlei Jia Jingwei Yu Jing Liu Meng Gao Hengqi Liu Lanfang Li Lihua Qiu Shiyong Zhou Bin Meng Wenchen Gong Zhengzi Qian Xianhuo Wang Huilai Zhang |
| author_facet | Jiesong Wang Junlei Jia Jingwei Yu Jing Liu Meng Gao Hengqi Liu Lanfang Li Lihua Qiu Shiyong Zhou Bin Meng Wenchen Gong Zhengzi Qian Xianhuo Wang Huilai Zhang |
| author_sort | Jiesong Wang |
| collection | DOAJ |
| description | Follicular lymphoma (FL) is a common B-cell lymphoma and typically affects the elderly population. It is urgently required to enhance our comprehension of disease-specific outcomes in elderly FL patients and identify a reliable predictive indicator to assess patient risk and guide treatment options for them. Therefore, we retrospectively analysed clinical data of 128 elderly patients (aged 60 years or older) with FL treated at Tianjin Medical University Cancer Institute & Hospital from 2002 to 2020. Univariate and multivariate analyses were performed to identify high risk prognostic factors, and we evaluated the predictive capacity of several prognostic scoring models by survival analysis and receiver operating characteristic (ROC) curves. Our analysis revealed that the age ≥70 was a significant independent predictor for both OS and PFS. FLIPI2 model can classify elderly FL patients into two risk groups with different prognoses, but the FLIPI and PRIMA-PI scoring systems may not be as applicable to this specific patient population. Based on the above results, we modified the FLIPI2 scoring system to set age ≥70 years as a risk factor and developed a novel prognostic index called the Age-adjusted FLIPI2 (A-FLIPI2), which effectively classified older FL patients into three distinct groups with significantly different outcomes. Among the four scoring systems evaluated, A-FLIPI2 showed the highest AUC for predicting risk of death (0.793) and disease progression (0.678). And the performance of A-FLIPI2 is validated in an external validation cohort. Thus, A-FLIPI2 is a better prognostic model for elderly FL patients. In conclusion, the newly developed prognostic index A-FLIPI2 in this study offers improved risk stratification for elderly FL patients. |
| format | Article |
| id | doaj-art-5a3c7e1cbbde45faae94191bc739fc52 |
| institution | Kabale University |
| issn | 2405-8440 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj-art-5a3c7e1cbbde45faae94191bc739fc522025-02-11T04:35:16ZengElsevierHeliyon2405-84402025-02-01114e42497The age-adjusted international prognostic index 2 (A-FLIPI2) for elderly patients with follicular lymphomaJiesong Wang0Junlei Jia1Jingwei Yu2Jing Liu3Meng Gao4Hengqi Liu5Lanfang Li6Lihua Qiu7Shiyong Zhou8Bin Meng9Wenchen Gong10Zhengzi Qian11Xianhuo Wang12Huilai Zhang13National Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; Department of Lymphoma & Head and Neck Oncology, College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, 350000, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; Department of Hematology, Cangzhou Central Hospital, Cangzhou, 061000, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; Department of Oncology, The Affiliated Hospital, Inner Mongolia Medical University, Hohhot, 010050, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, ChinaDepartment of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, ChinaDepartment of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, ChinaNational Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; Corresponding author. Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China.National Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; Corresponding author. Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China.National Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, and Department of Lymphoma, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; Corresponding author. Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China.Follicular lymphoma (FL) is a common B-cell lymphoma and typically affects the elderly population. It is urgently required to enhance our comprehension of disease-specific outcomes in elderly FL patients and identify a reliable predictive indicator to assess patient risk and guide treatment options for them. Therefore, we retrospectively analysed clinical data of 128 elderly patients (aged 60 years or older) with FL treated at Tianjin Medical University Cancer Institute & Hospital from 2002 to 2020. Univariate and multivariate analyses were performed to identify high risk prognostic factors, and we evaluated the predictive capacity of several prognostic scoring models by survival analysis and receiver operating characteristic (ROC) curves. Our analysis revealed that the age ≥70 was a significant independent predictor for both OS and PFS. FLIPI2 model can classify elderly FL patients into two risk groups with different prognoses, but the FLIPI and PRIMA-PI scoring systems may not be as applicable to this specific patient population. Based on the above results, we modified the FLIPI2 scoring system to set age ≥70 years as a risk factor and developed a novel prognostic index called the Age-adjusted FLIPI2 (A-FLIPI2), which effectively classified older FL patients into three distinct groups with significantly different outcomes. Among the four scoring systems evaluated, A-FLIPI2 showed the highest AUC for predicting risk of death (0.793) and disease progression (0.678). And the performance of A-FLIPI2 is validated in an external validation cohort. Thus, A-FLIPI2 is a better prognostic model for elderly FL patients. In conclusion, the newly developed prognostic index A-FLIPI2 in this study offers improved risk stratification for elderly FL patients.http://www.sciencedirect.com/science/article/pii/S2405844025008771Follicular lymphomaElderly patientsPrognostic factorsPrognostic model |
| spellingShingle | Jiesong Wang Junlei Jia Jingwei Yu Jing Liu Meng Gao Hengqi Liu Lanfang Li Lihua Qiu Shiyong Zhou Bin Meng Wenchen Gong Zhengzi Qian Xianhuo Wang Huilai Zhang The age-adjusted international prognostic index 2 (A-FLIPI2) for elderly patients with follicular lymphoma Heliyon Follicular lymphoma Elderly patients Prognostic factors Prognostic model |
| title | The age-adjusted international prognostic index 2 (A-FLIPI2) for elderly patients with follicular lymphoma |
| title_full | The age-adjusted international prognostic index 2 (A-FLIPI2) for elderly patients with follicular lymphoma |
| title_fullStr | The age-adjusted international prognostic index 2 (A-FLIPI2) for elderly patients with follicular lymphoma |
| title_full_unstemmed | The age-adjusted international prognostic index 2 (A-FLIPI2) for elderly patients with follicular lymphoma |
| title_short | The age-adjusted international prognostic index 2 (A-FLIPI2) for elderly patients with follicular lymphoma |
| title_sort | age adjusted international prognostic index 2 a flipi2 for elderly patients with follicular lymphoma |
| topic | Follicular lymphoma Elderly patients Prognostic factors Prognostic model |
| url | http://www.sciencedirect.com/science/article/pii/S2405844025008771 |
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