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Prognostic significance of histologic grade and Ki‐67 proliferation index in follicular lymphoma
Author(s) -
Xue Tian,
Yu BaoHua,
Yan WanHui,
Jiang XiangNan,
Tian Tian,
Zhou XiaoYan,
Li XiaoQiu
Publication year - 2020
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2778
Subject(s) - medicine , follicular lymphoma , rituximab , lymphoma , gastroenterology , international prognostic index , grading (engineering) , ki 67 , progression free survival , diffuse large b cell lymphoma , proliferation index , multivariate analysis , overall survival , oncology , immunohistochemistry , civil engineering , engineering
Abstract The prognostic value of histologic grading and the Ki‐67 proliferation index in follicular lymphoma (FL) is controversial. This study investigated the clinical usefulness of these two factors in Asian FL patients. Four hundred and thirty‐three patients diagnosed with FL were retrospectively reviewed with a median follow‐up time of 47.0 months (range, 24.0‐168.0). The 10‐year overall survival (OS) rate and progression‐free survival (PFS) rate were 91.0% and 47.1%, respectively. Grade 3B and grade 3B with diffuse large B cell lymphoma (DLBCL) showed a better PFS than grade 1‐3A ( P < 0.001), and similar findings were noted in patients who received rituximab‐containing regimens ( P = 0.002). In contrast, no significant differences in terms of OS or PFS were observed between grades 1‐2 and 3A. In addition, patients with Ki‐67 ≥ 30% had a significantly better PFS than patients with Ki‐67 < 30% ( P = 0.014), although the difference was eliminated in the multivariate analysis. Both grade and Ki‐67 index had no impact on prognosis in patients who did not receive rituximab treatment. In conclusion, grade 3A is closely related to grade 1‐2, as reflected by a similar indolent clinical course and a lower PFS rate than grade 3B/3B + DLBCL. In addition, a higher Ki‐67 index seems to have a positive effect on PFS in FL patients.