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Background  Survival in follicular lymphoma (FL) is highly variable, even within prognostic groups defined by tumor grade and the Follicular Lymphoma International Prognostic Index. Studies suggest that germline single nucleotide polymorphisms (SNPs) may hold prognostic information but further investigation is needed.    Methods  We explored the association between SNPs and FL outcome using two approaches: 1) Two independent genome-wide association studies (GWAS) of ~300.000 SNPs followed by a meta-analysis encompassing 586 FL patients diagnosed in Denmark/Sweden 1999–2002 and in the United States 2001–2006; and 2) Investigation of 22 candidate-gene variants previously associated with FL outcome in the Danish/Swedish cohort (N = 373). We estimated time to lymphoma-specific death (approach 1 and 2) and lymphoma progression (approach 2) with hazard ratios (HR) and 95% confidence intervals (CI) in a multivariable Cox regression model.    Results  In the GWAS meta-analysis, using a random effects model, no variants were associated with lymphoma-specific death at a genome-wide significant level (p < 5.0 ×10 −8 ). The strongest association was observed for tightly linked SNPs on 17q24 near the  ABCA10  and  ABCA6  genes (rs10491178 HR random  = 3.17, 95% CI 2.09-4.79, p random  = 5.24 ×10 −8 ). The  ABCA10  and  ABCA6  genes belong to a family of genes encoding for ABC transporter proteins, implicated in multidrug resistance. In line with a previous study, rs2466571 in  CD46  (HR = 0.73, 95% CI 0.58-0.91, p = 0.006) showed nominal association with lymphoma progression, as did two highly linked SNPs in  IL8  (rs4073 HR = 0.78, 95% CI 0.62-0.97, p = 0.02; rs2227307 HR = 0.75, 95% CI 0.60-0.94, p = 0.01) previously associated with overall survival.    Conclusions  The results suggest a possible role for multidrug resistance in FL survival and add to the evidence that genetic variation in  CD46  and  IL8  may have prognostic implications in FL. Our findings need further confirmation in other independent populations or in a larger multicenter GWAS.    Electronic supplementary material  The online version of this article (doi:10.1186/s12881-014-0113-6) contains supplementary material, which is available to authorized users.

A comprehensive evaluation of the role of genetic variation in follicular lymphoma survival