Variables associated with “high-risk FL” (increased risk of death, early recurrence, transformation)
| Variable . | Outcome . | Reference . |
|---|---|---|
| Clinical/patient based | ||
| Grade 3b vs grades 1-3a | Inferior OS | Wahlin et al,11 Mercadal et al12 |
| Increased β2 microglobulin from normal | Inferior PFS and OS | Press et al,13 Bachy et al14 |
| Large nodal mass (>7 cm) | Inferior PFS | Solal-Céligny et al,15 Nooka et al,16 Buske et al17 |
| Greater than 4 nodal sites | Inferior PFS and OS | Solal-Céligny et al15 |
| Bone marrow involvement | Inferior PFS and OS | Bachy et al14 |
| Low hemoglobin (under 12 g/dL) | Inferior PFS and OS | Solal-Céligny et al,15 Nooka et al16 |
| Advanced stage | Inferior PFS and OS | Brice et al,18 Buske et al17 |
| High FL tumor burden based on GELF criteria | Inferior PFS and OS | Brice et al,18 Buske et al17 |
| Low lymphocyte to monocyte ratio | Increased risk of transformation | Gao et al,19 Mohsen et al,20 Mozas et al21 |
| Imaging based | ||
| High baseline SUV max of PET scan | Inferior OS and increased risk of early disease progression (mixed data) | Mir et al,22 Barrington and Meignan23 |
| End of therapy PET positive (Deauville 4-5) | Inferior PFS and OS | Trotman et al3 |
| High total metabolic tumor volume | Inferior PFS and OS (mixed data) | Barrington and Meignan,23 Skander 2019,50 Meignan et al4 |
| Tumor based | ||
| 23-gene GEP signature score | Inferior PFS | Huet et al5 |
| Genomic alterations (gain of chromosome 2p; deletion 17p, subclonal TP53 mutations) | Inferior PFS | Qu et al24 |
| Low intratumoral immune infiltration | Increased risk of early progression | Tobin et al25 |
| High expression of genes from tumor associated macrophages | Inferior PFS and OS | Dave et al,26 Kridel et al27 |
| Increased ctDNA at diagnosis and at completion of therapy | Inferior PFS and OS | Delfau-Larue et al,6 Zohren et al,28 Sarkozy et al29 |
| Select mutations in several genes, including TP53, SOCS1, B2M, and MYD88 | Enriched in tumors of early progressed patients | Kridel et al30 |
| Treatment based | ||
| Disease recurrence within 24 months of diagnosis or therapy | Inferior OS | Casulo et al,31 Jurinovic et al,32 Maurer et al33 |
| Histologic transformation 18-24 months after diagnosis or therapy | Inferior OS | Link et al,8 Wagner-Johnson et al,34 Sarkozy et al35 |
| Multiply relapsed disease | Inferior PFS | Batlevi et al,9 Link et al,36 Rivas-Delgado et al10 |
| Refractory disease | Inferior PFS | Batlevi et al,9 Link et al,36 Rivas-Delgado et al10 |
| Variable . | Outcome . | Reference . |
|---|---|---|
| Clinical/patient based | ||
| Grade 3b vs grades 1-3a | Inferior OS | Wahlin et al,11 Mercadal et al12 |
| Increased β2 microglobulin from normal | Inferior PFS and OS | Press et al,13 Bachy et al14 |
| Large nodal mass (>7 cm) | Inferior PFS | Solal-Céligny et al,15 Nooka et al,16 Buske et al17 |
| Greater than 4 nodal sites | Inferior PFS and OS | Solal-Céligny et al15 |
| Bone marrow involvement | Inferior PFS and OS | Bachy et al14 |
| Low hemoglobin (under 12 g/dL) | Inferior PFS and OS | Solal-Céligny et al,15 Nooka et al16 |
| Advanced stage | Inferior PFS and OS | Brice et al,18 Buske et al17 |
| High FL tumor burden based on GELF criteria | Inferior PFS and OS | Brice et al,18 Buske et al17 |
| Low lymphocyte to monocyte ratio | Increased risk of transformation | Gao et al,19 Mohsen et al,20 Mozas et al21 |
| Imaging based | ||
| High baseline SUV max of PET scan | Inferior OS and increased risk of early disease progression (mixed data) | Mir et al,22 Barrington and Meignan23 |
| End of therapy PET positive (Deauville 4-5) | Inferior PFS and OS | Trotman et al3 |
| High total metabolic tumor volume | Inferior PFS and OS (mixed data) | Barrington and Meignan,23 Skander 2019,50 Meignan et al4 |
| Tumor based | ||
| 23-gene GEP signature score | Inferior PFS | Huet et al5 |
| Genomic alterations (gain of chromosome 2p; deletion 17p, subclonal TP53 mutations) | Inferior PFS | Qu et al24 |
| Low intratumoral immune infiltration | Increased risk of early progression | Tobin et al25 |
| High expression of genes from tumor associated macrophages | Inferior PFS and OS | Dave et al,26 Kridel et al27 |
| Increased ctDNA at diagnosis and at completion of therapy | Inferior PFS and OS | Delfau-Larue et al,6 Zohren et al,28 Sarkozy et al29 |
| Select mutations in several genes, including TP53, SOCS1, B2M, and MYD88 | Enriched in tumors of early progressed patients | Kridel et al30 |
| Treatment based | ||
| Disease recurrence within 24 months of diagnosis or therapy | Inferior OS | Casulo et al,31 Jurinovic et al,32 Maurer et al33 |
| Histologic transformation 18-24 months after diagnosis or therapy | Inferior OS | Link et al,8 Wagner-Johnson et al,34 Sarkozy et al35 |
| Multiply relapsed disease | Inferior PFS | Batlevi et al,9 Link et al,36 Rivas-Delgado et al10 |
| Refractory disease | Inferior PFS | Batlevi et al,9 Link et al,36 Rivas-Delgado et al10 |
GELF, Groupe d'Etude des Lymphomas Folliculaires; SUV, standard uptake value.