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The Prognostic Nutritional Index (PNI), a parameter combining serum albumin concentration and absolute lymphocyte count, is considered a measure of the nutritional and inflammatory status and the host's anti-tumor response. We analyzed the clinical characteristics and outcomes according to the PNI of 351 grades 1–3 A FL patients. Forty-one patients (12%) had a PNI ≤45, who were older and showed adverse baseline features. A low PNI was associated with a shorter PFS (only for patients >60 years), and OS (for all patients, 10-year OS, 52% versus 74%, p = 0.0001). The prognostic impact of the PNI on OS was confirmed in a multivariate model for patients >60 years (HR = 3, p = 0.006). In conclusion, the PNI is a readily accessible piece of information that can identify a small subset of FL patients with shorter survival, and it could be an aid to improve the nutritional status of patients prior to treatment initiation. [ABSTRACT FROM AUTHOR]

The lymphocyte-to-monocyte ratio (LMR) is a prognostic factor in different neoplasms, but its potential importance in follicular lymphoma (FL) is not well defined. We studied 384 FL patients for which the LMR was available at diagnosis. Baseline features and outcomes were compared between patients with an LMR ≤/>2.5. The 76 patients (20%) who had an LMR ≤2.5 were older and had a higher tumor burden. A low LMR was predictive of a lower 10-y progression-free survival (32 vs. 55%, p =.001) and overall survival (35 vs. 78%, p <.0001; HR = 2.3, p =.003 in a 6-element multivariable model). A low LMR was also an independent risk factor for histological transformation (11 vs. 6% at 10 years, p =.01). Likewise, patients with a low LMR had a higher rate of second malignancies. The potential utility of this widely available parameter and its contribution to well-established prognostic scores need to be explored in independent, prospective series. [ABSTRACT FROM AUTHOR]

We have analyzed in lymph nodes at diagnosis of 75 patients with follicular lymphoma (FL) the relationship between different T-cell subpopulations, assessed by immunohistochemistry (IHC) and flow cytometry (FC), with the outcome. CD4+cells were the most abundant T-cells in tumor tissue sections, whilst CD57+cells were the less frequent. In addition to nonambulatory performance status, advanced stage and FLIPI, low CD4+CD57+/CD4+ratio (p = .041), and low CD4+/CD8+ratio (p = .008) predicted poor overall survival (OS). Multivariate analysis showed that CD4+CD57+/CD4+ratio was the most important variable for OS. In conclusion, T-cell subpopulations, including CD4+CD57+/CD4+ratio analyzed by FC, could identify FL patients with favorable outcome. [ABSTRACT FROM AUTHOR]

Bcl-2/IgH rearrangement is the molecular hallmark of follicular lymphoma (FL) which is present in 70-90% of the cases at diagnosis. The clinical significance of this feature is controversial. The aim of this study was to analyze the bcl-2/IgH rearrangement by means of a PCR technique, and to correlate molecular findings with clinical characteristics and outcome. Sixty-nine patients (median age, 53 years; male/female ratio: 35/34) diagnosed with FL in a single institution were included in the study. A total of 77 DNA samples were analyzed. 54 were obtained from lymph node biopsy and 23 from peripheral blood or bone marrow. Bcl-2/IgH rearrangement was assessed for both the major breakpoint region (MBR) and the minor cluster region (mcr) breakpoints by a PCR technique. Thirty-nine out of sixty patients (65%) with assessable samples were found to have a bcl-2/IgH rearrangement in the MBR breakpoint, whereas bcl-2/IgH rearrangement in mcr was observed in one patient (2%) and no rearrangement at MBR or mcr in the remaining 20 patients (33%). Regarding the initial characteristics, patients with bcl-2/IgH rearrangements at MBR or mcr were younger (<65 years) than those with no rearrangement at these sites (p = 0.0001). No differences were found according to bcl-2/IgH rearrangement in terms of complete response rate, time to treatment failure and overall survival. In our series bcl-2/IgH rearrangement at MBR or mcr, which was found in 67% of the patients, was not correlated with response to treatment, survival nor time-to-treatment-failure. [ABSTRACT FROM AUTHOR]