Female patients with follicular lymphoma have a better prognosis if primary remission lasts over 24 months

Abstract

Findings regarding the role of sex in follicular lymphoma (FL) are contradictory and the prognostic value of sex among patients with early progression of disease (POD) remains unclear. We collected real-life data from nine hospitals in Finland and Spain including 1020 FL patients to study the influence of sex on disease outcome. The median follow-up duration was 67 months (range 0-226 months). Female patients showed better progression-free survival (PFS) (hazard ratio [HR], 0.720; 95% confidence interval [CI], 0.588-0.881), disease-specific survival (DSS) (HR, 0.653; 95% CI, 0.448-0.951), and overall survival (OS) (HR, 0.653; 95% CI, 0.501-0.853) than male patients. However, there were no significant sex differences in prognosis in patients with early POD. This study strengthens the understanding that male sex is an adverse prognostic factor for FL. However, this difference does not apply to patients with early POD.

Survival of patients with mantle cell lymphoma in the rituximab era: Retrospective binational analysis between 2000 and 2020

“…For patients who relapsed within 24 months of diagnosis, the median OS was 7 versus 41 months among patients experiencing a later relapse (p < 0.05). Similar to results from other cohorts on MCL and follicular lymphoma, 25,26 our results suggest that relapse within 24 months of diagnosis is associated with poor prognosis.…”

Progression-free survival after front line, second line and third line in patients with follicular lymphoma treated in clinical practice

“…The adverse impact on PFS1 of high-risk FLIPI scores, age, use of low-intensity or non-immunotherapy-containing regimens, a no-maintenance strategy, or POD24 are consistent in published data [17]. The correlation between sex and outcome is more controversial and inconsistent [18][19][20][21][22][23]. It is possible that male sex has a small negative association with prognosis that reaches significance only in some, but not all, studies, consistent with what has been documented in diffuse large B-cell lymphoma [24,25].…”

Survival by First-line Treatment Type and Timing of Progression Among Follicular Lymphoma Patients: A National Population-based Study in Sweden

“…We separately assessed POD24 since previous studies have focused on this time point. Follow‐up started at date of progression among POD24 patients, and at 24 months after treatment initiation among patients who were PF as in previous studies 21,29–31 . In the PF patient group, patients dying (n = 74) or being censored due to the end of study period (n = 6) within 24 months were excluded from this analysis (n = 80).…”

“…Follow-up started at date of progression among POD24 patients, and at 24 months after treatment initiation among patients who were PF as in previous studies. 21,[29][30][31] In the PF patient group, patients dying (n = 74) or being censored due to the end of study period (n = 6) within 24 months were excluded from this analysis (n = 80). OS was estimated using the Kaplan-Meier method by POD24 for the different treatment groups.…”