Population-based epidemiological data of follicular lymphoma in Poland: 15 years of observation

Abstract

Available epidemiological reports on follicular lymphoma (FL) often highlight a significant discrepancy between its high and low incidence rates in Western and Eastern Europe, respectively. The reasons behind that difference are not fully understood, but underreporting is typically presumed as one of the main factors. This study aimed to assess FL epidemiology in Poland based on 2000-2014 data from the Polish National Cancer Registry, which has 100% population coverage and over 90% completeness of the registration. All cases were coded according to ICD-10 and ICD-O-3 recommendations. The total number of registered FL cases was 3,928 with crude (CR) and standardized (SR) incidence rates of 0.72/10 5 and 0.87/10 5 , respectively. The median age of FL diagnosis was 61 years, with the male to female incidence ratio of 1.06. The distribution of morphological types of FL: not otherwise specified (NOS), grades 1, 2, or 3 were 72.58, 4.81, 12.88, and 9.73%, respectively. Among all reported mature B-cell non-Hodgkin lymphomas, FL was ranked the fourth in incidence, just after chronic lymphocytic leukemia/small lymphocytic lymphoma (CR 3.62/10 5 , SR 4.99/10 5), plasma cell neoplasms (CR 3.78/10 5 , SR 4.97/10 5) and diffuse B-cell lymphoma, NOS (CR 2.13/10 5 , SR 2.65/10 5). The systematic increase in FL incidence among females was observed. Our study confirms a lower FL incidence rate in Poland as compared to other European countries. Moreover, as our analysis was based on a registry with high data completeness, it provides evidence that reasons other than underreporting are responsible for FL incidence discrepancies between Eastern and Western Europe. Follicular lymphoma (FL) is one of the most common non-Hodgkin's lymphomas (NHLs) and its incidence varies between geographical regions. In Western Europe and US FL accounts for 20-40% of all NHLs, whereas in Eastern Europe, Asia, and developing countries, its prevalence is about threefold lower. FL affects mostly white adults of a median age of sixty, with a slightly higher incidence rate in females 1. There is an upward trend in the incidence of NHLs in Western countries, which can be attributed mainly to the increased incidence of FL 2. According to data from the Polish histopathological registry of lymphomas, FL accounted for less than 5% of all diagnoses reported in the 2007-2012 period 3. One of the main risk factors predisposing to FL is exposition to high doses of pesticides and herbicides, which may induce BCL2 gene translocation t(14;18)(q32;q21) 4. FL heterogeneity poses a diagnostic and therapeutical challenge, from early indolent lymphoma to aggressive transformation into therapy-resistant diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS). FL is composed of germinal follicle center B-cells containing centrocytes and centroblasts that almost always present focal follicular growth pattern 4,5. An absolute number of centroblasts per high-power microscopic field should be evaluated by a pathologist to classify FL into the histological grading sys...

Large-Scale Proteomic Analysis of Follicular Lymphoma Reveals Extensive Remodeling of Cell Adhesion Pathway and Identifies Hub Proteins Related to the Lymphomagenesis

“…However, our recent study confirmed a lower FL incidence rate in Poland as compared to other European countries. FL accounted for 6.3% of all B-NHLs, with 5.6% in the male and 6.9% in the female populations, respectively [ 6 ].…”

“…The HT rate of FL is difficult to estimate [ 11 ] and it is assumed about 2–3% per year from diagnosis [ 12 , 13 , 14 ]. Recently, significantly prolonged progression-free survival was observed when treated with modern therapies [ 15 , 16 ], however its remains incurable for the majority of elderly individuals [ 6 , 17 , 18 ]. Therefore, extensive “omics” studies dealing with the molecular aspect of FL are highly recommended.…”

Current status and achievements of Polish haemato-oncology

“…The next study, based on 2000-2014 data from the Polish National Cancer Registry, confirmed a lower FL incidence rate in Poland compared to other European countries. FL was ranked fourth in incidence (CR 0.72/10 5 , SR 0.87/10 5 ) among all reported mature B-cell non-Hodgkin lymphomas, after CLL/ /SLL (CR 3.62/10 5 , SR 4.99/10 5 ), PCM (CR 3.78/10 5 , SR 4.97/10 5 ) and DLBCL, NOS (CR 2.13/10 5 , SR 2.65/10 5 ) [94]. A scheme of comprehensive haematopathological diagnostics of aggressive B-cell lymphomas based on morphology, immune profile and evaluation of MYC, BCL2, and BCL6 gene statuses was proposed, and this was introduced in Poland after the publication of revised WHO classifications in 2017 [95].…”

Economic Consequences of Administering Obinutuzumab as a Short Duration Infusion in Italian Patients with Advanced Follicular Lymphoma: A Cost Analysis

“…Follicular lymphoma (FL) is one of the most common lymphomas representing about 12-19% of all non-Hodgkin lymphomas (NHL) [1,2]. In Italy, the rate of new cases of FL is equal to 2.85 (95% CI: 2.78-2.92) per 100,000 person/year: its incidence increases with age-FL mainly affects adults over the age of 60, for which annual standardized incidence is up to 6.32 in people older than 65 years-with no differences between men (2.80) and women (2.90) [3].…”

“…1 Caregiver costs is a weighted mean that takes into account distribution of formal and informal care…”