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Time to lymphoma treatment within 24 months in 'watch and wait' follicular lymphoma is associated with inferior outcomes: A multicentre analysis

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机构： [1]Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, State key Laboratory of Druggability Evaluation and Systematic Translational Medicine, 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, China. [2]Department of Hematology, Cangzhou Central Hospital, Cangzhou, China. [3]Department of Hematology, Peking University Third Hospital, Beijing, China. [4]Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China. [5]Department of Lymphoma and Head and Neck Oncology, College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China. [6]Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China. [7]Department of Hematology, The Fourth Hospital of Hebei Medical University (Hebei Tumor Hospital), Shijiazhuang, China. [8]Department of Lymphoma and Hematology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China. [9]Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. [10]Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China. [11]Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China. [12]Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China. [13]Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China. [14]Department of Lymphoma, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, Xinjiang, China. [15]Department of Lymphoma, Fudan University Shanghai Cancer Center, Shanghai, China. [16]Department of Hematology, The First Hospital of Jilin University, Changchun, Jilin, China. [17]Department of Medical Oncology, Cancer Center, West China Hospital of Sichuan University, Chengdu, China. [18]Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital&Institute, Beijing, China. [19]Department of Medical Oncology, Harbin Medical University Cancer Hospital, Heilongjiang Cancer Prevention and Treatment Institute, Harbin, Heilongjiang Province, China.

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Some 'watch and wait' (W&W) FL patients suffer from rapid progression in a short term. Herein, we sought to identify these patients and also develop a risk score to screen them at diagnosis. Between 2008 and 2022, a total of 411 FL patients managed by the W&W strategy from 16 cancer centres were retrospectively enrolled in this study, and their time to lymphoma treatment (TLT) and progression-free survival (PFS) were evaluated. Thirty-five percent of W&W FL patients experienced TLT within 24 months (TLT24) after diagnosis. Their 5-year PFS rate was significantly lower than those without treatment at 24 months (62.3% vs. 89.5%). In multivariable analysis, five factors were identified as independent predictors of TLT24: stages III-IV, β2 microglobulin ≥3 mg/L, lymphocyte-to-monocyte ratio <3.8, bone marrow involvement and spleen enlargement (above umbilical line). Their AUCs for TLT24 were 0.76 (95% CI, 0.70-0.82) in the training cohort and 0.76 (95% CI, 0.67-0.85) in the validation cohort respectively. Risk groups were also associated with PFS (p < 0.001). In FL patients initially managed by W&W, TLT24 was associated with poor outcomes. This multivariable model helps screening for predicting TLT24, which may be useful to identify candidates for early interventional treatment.© 2024 British Society for Haematology and John Wiley & Sons Ltd.

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大类 | 2 区

医学

小类 | 2 区血液学

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Q1 HEMATOLOGY

影响因子： 5.1 最新[2023版] 5.7 最新五年平均 5.1 出版当年[2023版] 0 出版当年五年平均 5.1 出版前一年[2023版]

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第一作者机构： [1]Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, State key Laboratory of Druggability Evaluation and Systematic Translational Medicine, 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, China. [2]Department of Hematology, Cangzhou Central Hospital, Cangzhou, China.

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