External Validation of the FLIPI Risk Score Measured at Diagnosis and POD24 Among Individuals With Follicular Lymphoma at the Time of Subsequent Relapse

Devon J Boyne; Neil Chua; Carolyn Owen; Ofodile Joe-Uzuegbu; Huma Shakir; Priyanka Gogna; Tamer N Jarada; Darren R Brenner; Julia Elia-Pacitti; Emmanuel M Ewara; Winson Y Cheung

doi:10.1016/j.clml.2023.05.013

External Validation of the FLIPI Risk Score Measured at Diagnosis and POD24 Among Individuals With Follicular Lymphoma at the Time of Subsequent Relapse

Clin Lymphoma Myeloma Leuk. 2023 Sep;23(9):e277-e285. doi: 10.1016/j.clml.2023.05.013. Epub 2023 May 29.

Authors

Affiliations

¹ Oncology Outcomes Research Initiative, University of Calgary, Calgary, AB, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: devon.boyne1@ucalgary.ca.
² Department of Medical Oncology and Hematology, Cross Cancer Institute, Edmonton, AB, Canada.
³ Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁴ Oncology Outcomes Research Initiative, University of Calgary, Calgary, AB, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁵ Oncology Outcomes Research Initiative, University of Calgary, Calgary, AB, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Science, University of Calgary, Calgary, AB, Canada.
⁶ Janssen Inc., Toronto, ON, Canada.
⁷ Oncology Outcomes Research Initiative, University of Calgary, Calgary, AB, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

PMID: 37331847
DOI: 10.1016/j.clml.2023.05.013

Abstract

Background: The Follicular lymphoma international prognostic index (FLIPI) risk score and POD24 have previously been shown to have prognostic value in follicular lymphoma (FL), but the extent to which they can inform prognosis at the time of subsequent relapse is uncertain.

Patients and methods: We conducted a longitudinal cohort study of individuals diagnosed with FL between 2004 and 2010 in Alberta, Canada who received front-line therapy and subsequently relapsed. FLIPI covariates were measured prior to the initiation of front-line therapy. Median overall survival (OS), progression-free survival (PFS2), and time to next treatment (TTNT2) were estimated from the time of relapse.

Results: A total of 216 individuals were included. The FLIPI risk score was highly prognostic at the time of relapse for OS (c-statistic = 0.70; HR_{[High vs. Low]} = 7.38; 95% CI: 3.05-17.88), PFS2 (c-statistic = 0.68; HR_{[High vs. Low]} = 5.84; 95% CI: 2.93-11.62) and TTNT2 (c-statistic = 0.68; HR_{[High vs. Low]} = 5.72; 95% CI: 2.87-11.41). POD24 was not prognostic at the time of relapse for either OS, PFS2, or TTNT2 (c-statistic = 0.55).

Conclusion: The FLIPI score measured at diagnosis may help with the risk stratification of individuals with relapsed FL.

Keywords: Oncology; Precision medicine; Real-world evidence; Risk prediction; Survival.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Longitudinal Studies
Lymphoma, Follicular* / diagnosis
Lymphoma, Follicular* / drug therapy
Lymphoma, Follicular* / pathology
Neoplasm Recurrence, Local
Prognosis
Retrospective Studies
Risk Factors