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Risk factors for POD24 in patients with previously untreated follicular lymphoma: a systematic review and meta-analysis

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A Correction to this article was published on 18 October 2022

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Abstract

Progression of disease within 24 months (POD24) is strongly associated with a poor outcome in patients with follicular lymphoma (FL). Our study aimed to identify the potential risk factors for POD24 in patients with FL. Medline, EMBASE and the Cochrane Library were systematically searched from the earliest record to September 2020. Studies investigating the prognostic factors for POD24 in patients with newly diagnosed grade 1-3a FL were included. Among 10,014 pieces of literature, a total of 90 studies investigating 82 risk factors were included for qualitative analysis. Meta-analyses were performed in 31 studies with 11 factors. Results showed that elevated sIL-2R, β2m and LDH, total metabolic tumour volume > 510 cm3, vitamin D < 20 ng/mL, grade 3a and lymphoma-associated macrophages/high-power field ≥ 15 were significantly associated with an increased risk of POD24. No significant association was found between POD24 and the ALC/AMC ratio, sex, T effector signature or EZH2 genetic alteration. Additionally, minimal residual disease, Ki-67, PD-1 and TP53 were analysed narratively. Overall, this is the first study that comprehensively analysed the prognostic factors associated with POD24 in FL patients. We have confirmed the significance value of several common prognostic factors as well as others not commonly included in clinical study, helping to construct an integrated and more efficient model.

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Acknowledgements

The authors thank Margueritte White M.D. of GlobalCommunityWriter for the language editing.

Funding

The study was supported by the National Natural Science Foundation of China (grant numbers 81770213 and 81670184), Natural Science Foundation of Tianjin (grant numbers 19JCYBJC26500 and 18JCZDJC45100), Project of Tianjin Municipal Health Bureau (grant number 15KG145), National Key New Drug Creation Special Programs (grant numbers 2017ZX09304-021 and 2018ZX09201015), Clinical Oncology Research Fund of CSCO (grant number Y-XD2019-162) and Shanghai Roche Pharmaceuticals Ltd., China.

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Author notes

  1. Fenghua Gao, Tingting Zhang and Hengqi Liu contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Lymphoma, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin’s Clinical Research Center for Cancer, the Sino-US Center for Lymphoma and Leukemia Research, Huanhuxi Road, Tiyuanbei, Hexi District, Tianjin, 300060, China

    Fenghua Gao, Tingting Zhang, Hengqi Liu, Wei Li, Xianming Liu, Lihua Qiu, Lanfang Li, Shiyong Zhou, Zhengzi Qian, Xianhuo Wang & Huilai Zhang

  2. Systematic Review Solutions Ltd, The Ingenuity Centre, Nottingham, UK

    Sitong Dong & Sai Zhao

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  1. Fenghua Gao
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Contributions

Fenghua Gao: formal analysis, investigation, writing—original draft; Tingting Zhang: formal analysis, investigation, writing—review and editing; Hengqi Liu: investigation, visualisation; Wei Li: data curation, formal analysis, methodology; Xianming Liu: data curation, formal analysis, methodology; Lihua Qiu: data curation, formal analysis, methodology; Lanfang Li: data curation, formal analysis, methodology; Shiyong Zhou: data curation, formal analysis, methodology; Zhengzi Qian: data curation, formal analysis, methodology; Huilai Zhang and Xianhuo Wang: conceptualisation, supervision, writing—review and editing.

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Correspondence to Xianhuo Wang or Huilai Zhang.

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The authors Sitong Dong and Sai Zhao were employed by Huilai Zhang. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Gao, F., Zhang, T., Liu, H. et al. Risk factors for POD24 in patients with previously untreated follicular lymphoma: a systematic review and meta-analysis. Ann Hematol 101, 2383–2392 (2022). https://doi.org/10.1007/s00277-022-04914-8

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