Examination of the follicular lymphoma international prognostic index (FLIPI) in the national lymphocare study (NLCS): A prospective US patient cohort treated predominantly in community practices

A. K. Nooka, C. Nabhan, X. Zhou, M. D. Taylor, M. Byrtek, Thomas P Miller, J. W. Friedberg, A. D. Zelenetz, B. K. Link, J. R. Cerhan, H. Dillon, R. Sinha, P. J. Shenoy, D. Levy, K. Dawson, J. H. Hirata, C. R. Flowers

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Because follicular lymphoma (FL) patients have heterogeneous outcomes, the FL international prognostic index (FLIPI) was developed to risk-stratify patients and to predict survival. However, limited data exist regarding the role of FLIPI in the era of routine first-line rituximab (R) and R-chemotherapy regimens and in the setting of community oncology practices. Patients and Methods: We evaluated the outcome data from the National LymphoCare Study (NLCS), a prospective, observational cohort study, which collects data on patients with FL in the United States (US) community practices. Results: Among 1068 male and 1124 female patients with FLIPI data, most were treated in US community practices (79%); 35% were FLIPI good risk, 30% intermediate risk, and 35% poor risk. FLIPI risk groups were significant predictors of overall survival (OS) and progression-free survival (PFS) for patients who undergo watchful waiting (WW), and those who receive non-R-containing regimens, R-alone, and R-chemotherapy combinations. Conclusions: In the setting of contemporary practice with routine R use, stratifying patients into good, intermediate, and poor FLIPI risk groups predicts distinct outcomes in terms of OS and PFS. FLIPI remains an important prognostic index in the R era and should be used in clinical practices to support discussions about prognosis.

Original languageEnglish (US)
Article numbermds429
Pages (from-to)441-448
Number of pages8
JournalAnnals of Oncology
Volume24
Issue number2
DOIs
StatePublished - Feb 2013

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Follicular Lymphoma
Prospective Studies
Disease-Free Survival
Survival
Watchful Waiting
Combination Drug Therapy
Observational Studies
Cohort Studies
Drug Therapy

Keywords

  • Community practice
  • FLIPI
  • Follicular lymphoma
  • NLCS

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Examination of the follicular lymphoma international prognostic index (FLIPI) in the national lymphocare study (NLCS) : A prospective US patient cohort treated predominantly in community practices. / Nooka, A. K.; Nabhan, C.; Zhou, X.; Taylor, M. D.; Byrtek, M.; Miller, Thomas P; Friedberg, J. W.; Zelenetz, A. D.; Link, B. K.; Cerhan, J. R.; Dillon, H.; Sinha, R.; Shenoy, P. J.; Levy, D.; Dawson, K.; Hirata, J. H.; Flowers, C. R.

In: Annals of Oncology, Vol. 24, No. 2, mds429, 02.2013, p. 441-448.

Research output: Contribution to journalArticle

Nooka, AK, Nabhan, C, Zhou, X, Taylor, MD, Byrtek, M, Miller, TP, Friedberg, JW, Zelenetz, AD, Link, BK, Cerhan, JR, Dillon, H, Sinha, R, Shenoy, PJ, Levy, D, Dawson, K, Hirata, JH & Flowers, CR 2013, 'Examination of the follicular lymphoma international prognostic index (FLIPI) in the national lymphocare study (NLCS): A prospective US patient cohort treated predominantly in community practices', Annals of Oncology, vol. 24, no. 2, mds429, pp. 441-448. https://doi.org/10.1093/annonc/mds429
Nooka, A. K. ; Nabhan, C. ; Zhou, X. ; Taylor, M. D. ; Byrtek, M. ; Miller, Thomas P ; Friedberg, J. W. ; Zelenetz, A. D. ; Link, B. K. ; Cerhan, J. R. ; Dillon, H. ; Sinha, R. ; Shenoy, P. J. ; Levy, D. ; Dawson, K. ; Hirata, J. H. ; Flowers, C. R. / Examination of the follicular lymphoma international prognostic index (FLIPI) in the national lymphocare study (NLCS) : A prospective US patient cohort treated predominantly in community practices. In: Annals of Oncology. 2013 ; Vol. 24, No. 2. pp. 441-448.
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abstract = "Background: Because follicular lymphoma (FL) patients have heterogeneous outcomes, the FL international prognostic index (FLIPI) was developed to risk-stratify patients and to predict survival. However, limited data exist regarding the role of FLIPI in the era of routine first-line rituximab (R) and R-chemotherapy regimens and in the setting of community oncology practices. Patients and Methods: We evaluated the outcome data from the National LymphoCare Study (NLCS), a prospective, observational cohort study, which collects data on patients with FL in the United States (US) community practices. Results: Among 1068 male and 1124 female patients with FLIPI data, most were treated in US community practices (79{\%}); 35{\%} were FLIPI good risk, 30{\%} intermediate risk, and 35{\%} poor risk. FLIPI risk groups were significant predictors of overall survival (OS) and progression-free survival (PFS) for patients who undergo watchful waiting (WW), and those who receive non-R-containing regimens, R-alone, and R-chemotherapy combinations. Conclusions: In the setting of contemporary practice with routine R use, stratifying patients into good, intermediate, and poor FLIPI risk groups predicts distinct outcomes in terms of OS and PFS. FLIPI remains an important prognostic index in the R era and should be used in clinical practices to support discussions about prognosis.",
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T1 - Examination of the follicular lymphoma international prognostic index (FLIPI) in the national lymphocare study (NLCS)

T2 - A prospective US patient cohort treated predominantly in community practices

AU - Nooka, A. K.

AU - Nabhan, C.

AU - Zhou, X.

AU - Taylor, M. D.

AU - Byrtek, M.

AU - Miller, Thomas P

AU - Friedberg, J. W.

AU - Zelenetz, A. D.

AU - Link, B. K.

AU - Cerhan, J. R.

AU - Dillon, H.

AU - Sinha, R.

AU - Shenoy, P. J.

AU - Levy, D.

AU - Dawson, K.

AU - Hirata, J. H.

AU - Flowers, C. R.

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N2 - Background: Because follicular lymphoma (FL) patients have heterogeneous outcomes, the FL international prognostic index (FLIPI) was developed to risk-stratify patients and to predict survival. However, limited data exist regarding the role of FLIPI in the era of routine first-line rituximab (R) and R-chemotherapy regimens and in the setting of community oncology practices. Patients and Methods: We evaluated the outcome data from the National LymphoCare Study (NLCS), a prospective, observational cohort study, which collects data on patients with FL in the United States (US) community practices. Results: Among 1068 male and 1124 female patients with FLIPI data, most were treated in US community practices (79%); 35% were FLIPI good risk, 30% intermediate risk, and 35% poor risk. FLIPI risk groups were significant predictors of overall survival (OS) and progression-free survival (PFS) for patients who undergo watchful waiting (WW), and those who receive non-R-containing regimens, R-alone, and R-chemotherapy combinations. Conclusions: In the setting of contemporary practice with routine R use, stratifying patients into good, intermediate, and poor FLIPI risk groups predicts distinct outcomes in terms of OS and PFS. FLIPI remains an important prognostic index in the R era and should be used in clinical practices to support discussions about prognosis.

AB - Background: Because follicular lymphoma (FL) patients have heterogeneous outcomes, the FL international prognostic index (FLIPI) was developed to risk-stratify patients and to predict survival. However, limited data exist regarding the role of FLIPI in the era of routine first-line rituximab (R) and R-chemotherapy regimens and in the setting of community oncology practices. Patients and Methods: We evaluated the outcome data from the National LymphoCare Study (NLCS), a prospective, observational cohort study, which collects data on patients with FL in the United States (US) community practices. Results: Among 1068 male and 1124 female patients with FLIPI data, most were treated in US community practices (79%); 35% were FLIPI good risk, 30% intermediate risk, and 35% poor risk. FLIPI risk groups were significant predictors of overall survival (OS) and progression-free survival (PFS) for patients who undergo watchful waiting (WW), and those who receive non-R-containing regimens, R-alone, and R-chemotherapy combinations. Conclusions: In the setting of contemporary practice with routine R use, stratifying patients into good, intermediate, and poor FLIPI risk groups predicts distinct outcomes in terms of OS and PFS. FLIPI remains an important prognostic index in the R era and should be used in clinical practices to support discussions about prognosis.

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