| Objective:To analyze the clinical characteristics of patients with follicular lymphoma(FL)and the relationship between treatment efficacy and prognostic factors.Methods:The clinical data of 41 FL patients hospitalized in the Department of Hematology,Second Hospital of Shanxi Medical University from June 2015 to December 2021 were collected to analyze the relationship between clinical characteristics,biological characteristics and complete remission(CR)of the patients,and the correlated factors affecting the prognosis of the patients were analyzed by COX multifactor regression model.Results:1.Of the 41 initial FL patients,24 were male and 17 were female.The median age of onset was 56 years.31 cases had lymph node enlargement as the first symptom,13cases had B symptoms,and 4 cases had bone marrow involvement.4,7,20,and 10 cases had Ann Arbor stages I-IV,respectively.The risk of PRIMA-PI was 16,2,and 23 cases in descending order.27 cases had a FLIPI score of≤2 and 14 cases had a score of>2.26cases had CD4~+T cells≤30%,21 cases had NK cells≤8%,17 cases had Ki-67>30%,and14 cases were CD5-positive.All patients expressed CD20.2.All 41 patients were treated with multiple cycles,and all patients were evaluated for efficacy after completing 6 to 8 cycles of treatment.37 patients were treated with rituximab in combination with chemotherapy(R+chemotherapy),34 of which were treated with R+chemotherapy as first-line regimen,3 of which were converted to R+chemotherapy for poor first-line efficacy,and 4 patients were treated with chemotherapy.27 patients had CR,with a CR rate of 65.9%,3 had partial remission PR(Partial Remission(PR),9 patients with disease progression(PD),2 patients died during treatment,the cause of death was severe infection,bone marrow suppression,8 patients were treated with R maintenance therapy,2 cases developed lung infection after R maintenance therapy,6 cases reached complete remission by the end of follow-up.12cases had POD24,the incidence was 29.2%.3 patients underwent autologous hematopoietic stem cell transplantation(Auto-HSCT,ASCT)for poor outcome,one developed severe infection after transplantation,and two achieved complete remission by the end of follow-up.3.The results showed that the CR rate in the age≤60 years group was higher than that in the age>60 years group,the CR rate in the FLIPI≤2 group was higher than that in the FLIPI>2 group,the CR rate in the pathological grade 1 to 2 group was higher than that in the grade 3 group,the CR rate in the CD4~+T cell elevated group was higher than that in the reduced group,the CR rate in the Ki-67≤30%group was higher than that in the Ki-67>30%group,and the CR rate in the first-line treatment regimen including rituximab was higher than that in the first treatment without R group(first treatment with R).The CR rate was higher in the group with elevated CD4~+T cells than in the group with decreased CD4~+T cells,the CR rate was higher in the group with Ki-67≤30%than in the group with Ki-67>30%,and the CR rate was higher in the group with first-line treatment regimen including rituximab(first treatment with R)than in the group with first treatment without R(all P<0.05).Prognostic univariate analysis of the above indicators showed that the PFS rate was higher in the age≤60 years group than in the age>60 years group,the PFS rate was higher in the NK cells>8%group than in the NK cells≤8%group,and the PFS rate was higher in the Ki-67≤30%group than in the Ki-67>30%group(all P<0.05).4.The multifactorial results showed that age(P=0.020)and Ki-67(P=0.037)were independent risk factors affecting the prognosis of FL patients.Conclusion:1.FL is mostly seen in middle-aged and elderly patients,with a median age of onset of 56 years,with lymph node enlargement first seen,some patients with B symptoms,a few patients with bone marrow involvement,the vast majority of patients expressing CD20,Ki-67,CD5 positive patients are less common.2.The CR rate was higher in patients aged≤60 years,pathological grade 1 to 2group,FLIPI≤2 score,reduced CD4~+T cells,Ki-67≤30%,and first treatment containing R.3.age>60 years group,Ki-67>30%group,and NK cells≤8%group affected FL patients were poor prognostic factors for PFS,and age(P=0.020)and Ki-67(P=0.037)were independent risk factors for PFS in FL patients.4.Early R maintenance therapy can significantly prolong PFS in FL patients,while for patients with early progression,ASCT within one year after the first relapse can significantly improve the prognosis.5.Early identification of people at high risk of POD24 is beneficial for developing better treatment plans,thus improving patient prognosis. |
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