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Int J Hematol. 2016 Dec;104(6):692-699. Epub 2016 Oct 6.

FCG (FLIPI, Charlson comorbidity index, and histological grade) score is superior to FLIPI in advanced follicular lymphoma.

Author information

1
Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia. bimihalje2802@gmail.com.
2
Faculty of Medicine, University of Belgrade, Belgrade, Serbia. bimihalje2802@gmail.com.
3
Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.
4
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
5
Clinical Hospital Centre "Bezanijska Kosa", Belgrade, Serbia.
6
Clinic for Oncology, Clinical Centre Nis, Nis, Serbia.
7
Department of Histopathology, Clinical Centre of Serbia, Belgrade, Serbia.
8
Department of Statistics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Abstract

The Follicular Lymphoma International Prognostic Index (FLIPI) is widely used in the identification of risk groups among follicular lymphoma (FL) patients. The aim of the present study was to evaluate the prognostic value of FLIPI combined with the Charlson comorbidity index (CCI) and histological grade of lymphoma. 224 newly diagnosed FL patients (median age 56 years) treated with immunochemotherapy were retrospectively analysed. Low FLIPI had 21.0 % of patients, intermediate 28.1 % and high 46.9 %. 50.9 % of patients had no comorbidities. Only 7.1 % of patients had a high CCI score (≥2), while 25.9 % of patients were histological grade 3. Parameters that influenced overall survival were evaluated using Cox regression analysis, in which CCI, FLIPI and histological grade (p < 0.05) retained prognostic significance. By combining these parameters, we have developed the FCG score, which incorporates FLIPI, CCI, and histological grade. This score defines three risk categories (low: 41.5 %; intermediate: 37.5 %; high: 13.4 %), associated with significantly different survival (p < 0.0001); this consequently improves discriminative power by 9.1 % compared to FLIPI. FCG score represents a possible new prognostic index, highlighting the role of the patient's clinical state and the histological characteristics of disease, as indicated by comorbidity index and histological grade of lymphoma.

KEYWORDS:

Comorbidity index; FLIPI; Follicular lymphoma; Histological grade

PMID:
27714586
DOI:
10.1007/s12185-016-2099-7
[Indexed for MEDLINE]

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