Factors Affecting the Clinical Course of Follicular Lymphoma: A Multistate Survival Analysis Using Individual Patient Data from Eight Multicenter Randomized Clinical Trials. - Université de Lille
Article Dans Une Revue Clinical Lymphoma & Myeloma & Leukemia Année : 2022

Factors Affecting the Clinical Course of Follicular Lymphoma: A Multistate Survival Analysis Using Individual Patient Data from Eight Multicenter Randomized Clinical Trials.

J. G. Dixon
  • Fonction : Auteur
Ç. Çağlayan
  • Fonction : Auteur
D. Chihara
  • Fonction : Auteur
T. Nielsen
  • Fonction : Auteur
N. Dimier
  • Fonction : Auteur
J. Zheng
  • Fonction : Auteur
A. K. Wall
  • Fonction : Auteur
G. Salles
  • Fonction : Auteur
R. Marcus
  • Fonction : Auteur
M. Herold
  • Fonction : Auteur
E. Kimby
  • Fonction : Auteur
K. A. Blum
  • Fonction : Auteur
M. Ghielmini
  • Fonction : Auteur
Q. Shi
  • Fonction : Auteur
C. R. Flowers
  • Fonction : Auteur

Résumé

Introduction/Background Leveraging the Follicular Lymphoma Analysis of Surrogacy Hypothesis database of individual patient data from first-line clinical trials, we studied the clinical course of follicular lymphoma (FL) and investigated clinical factors associated with FL outcomes. Patients and Methods We examined 2428 patients from 8 randomized trials using multistate survival models with 4 states: induction treatment, progression, death from FL, and death from other causes. We utilized Aalen-Johansen estimator and Cox models to assess the likelihood of FL outcomes and quantify predictors’ effects. Results Two-year progression, FL-related death, and death from other causes estimates were 26.5%, 3.4% and 1.4%, respectively. FL-associated deaths were the primary cause of mortality within 10 years of follow-up. Male sex (hazard ratio: 1.25; 95% confidence interval: 1.05-1.47), > 4 involved nodal areas (1.51; 1.23-1.86), elevated LDH (1.20; 1.01-1.43), low hemoglobin (1.44; 1.15-1.81), and elevated β-2 levels (1.23; 1.02-1.47) increased risk of progression. CD20-targeting agents reduced risks for progression (0.29; 0.22-0.39), death from FL (0.05; 0.01-0.20), and death from other causes without progression (0.13; 0.05-0.33) and following progression (0.52; 0.30-0.92). Estimated 2-year progression rates were 22.3% and 43.5% with or without CD20-targeting agents, respectively. Two-year FL-associated mortality rate was 8.3% among patients without CD20-targeting agents, 5.4% with B-symptoms, 4.9% with elevated LDH, and 9.1% with low hemoglobin. Conclusion This study identified independent contributions of baseline clinical factors to distinct outcomes for patients with FL following first-line therapy on a clinical trial. Similar analytical approaches are needed to increase understanding of factors that influence FL outcomes in other settings.
Fichier non déposé

Dates et versions

hal-04212003 , version 1 (20-09-2023)

Identifiants

Citer

J. G. Dixon, Ç. Çağlayan, D. Chihara, T. Nielsen, N. Dimier, et al.. Factors Affecting the Clinical Course of Follicular Lymphoma: A Multistate Survival Analysis Using Individual Patient Data from Eight Multicenter Randomized Clinical Trials.. Clinical Lymphoma & Myeloma & Leukemia, 2022, Clinical Lymphoma & Myeloma & Leukemia, 22 (11), pp.e1009-e1018. ⟨10.1016/j.clml.2022.07.015⟩. ⟨hal-04212003⟩

Collections

UNIV-LILLE
10 Consultations
0 Téléchargements

Altmetric

Partager

More