Clinical features and prognostic factors in 49 patients with follicular lymphoma at a single center: A retrospective analysis.

Background: Follicular lymphoma (FL) is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate. FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.

Aim: To explore the clinical features, curative effects, and prognostic factors of FL.

Methods: Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined. These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining. The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas. Ann Arbor staging was performed according to the imaging and bone marrow examination results. Risk stratification of all patients was performed based on the International Prognostic Index (IPI), age-adjusted IPI, Follicular Lymphoma International Prognosis Index (FLIPI), and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.

Results: The age of onset in patients ranged from 24 to 76 years, with a median age of 51 years. Most patients developed the disease at 40-59 years of age, and the male:female ratio was 1.6:1. No significant difference was noted in the curative effect between the non-chemotherapy, combined chemotherapy, and other chemotherapy regimens ( > 0.05). Hemoglobin (Hb) level < 120 g/L, Ki-67 value > 50%, bone marrow involvement, and clinical stages III-IV were associated with a poor prognosis of FL ( < 0.05). However, the influence of other indicators was not statistically significant. Risk grouping was performed using the FLIPI, and the results showed that 24.5%, 40.8%, and 34.7% of patients were in the low-, moderate-, and high-risk groups, respectively. According to the survival analysis results, the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups ( < 0.05).

Conclusion: FL mainly occurs in middle-aged and elderly men, primarily affecting lymph nodes and bone marrow. Hb level, Ki-67 value, bone marrow involvement, and clinical staging were used to evaluate prognosis.