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FCG (FLIPI, Charlson comorbidity index, and histological grade) score is superior to FLIPI in advanced follicular lymphoma

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Abstract

The Follicular Lymphoma International Prognostic Index (FLIPI) is widely used in the identification of risk groups among follicular lymphoma (FL) patients. The aim of the present study was to evaluate the prognostic value of FLIPI combined with the Charlson comorbidity index (CCI) and histological grade of lymphoma. 224 newly diagnosed FL patients (median age 56 years) treated with immunochemotherapy were retrospectively analysed. Low FLIPI had 21.0 % of patients, intermediate 28.1 % and high 46.9 %. 50.9 % of patients had no comorbidities. Only 7.1 % of patients had a high CCI score (≥2), while 25.9 % of patients were histological grade 3. Parameters that influenced overall survival were evaluated using Cox regression analysis, in which CCI, FLIPI and histological grade (p < 0.05) retained prognostic significance. By combining these parameters, we have developed the FCG score, which incorporates FLIPI, CCI, and histological grade. This score defines three risk categories (low: 41.5 %; intermediate: 37.5 %; high: 13.4 %), associated with significantly different survival (p < 0.0001); this consequently improves discriminative power by 9.1 % compared to FLIPI. FCG score represents a possible new prognostic index, highlighting the role of the patient’s clinical state and the histological characteristics of disease, as indicated by comorbidity index and histological grade of lymphoma.

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Acknowledgment

Funding was provided by Ministry of Education, Science and Technological Development, Republic of Serbia (Grant No. III41004).

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Authors and Affiliations

  1. Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia

    Biljana Mihaljevic, Jelena Jelicic, Bosko Andjelic, Darko Antic, Jelena Bila, Vladislava Djurasinovic, Aleksandra Sretenovic, Vojin Vukovic, Mihailo Smiljanic & Milena Todorovic Balint

  2. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Biljana Mihaljevic, Bosko Andjelic, Darko Antic, Olivera Markovic, Jelena Bila & Milena Todorovic Balint

  3. Clinical Hospital Centre “Bezanijska Kosa”, Belgrade, Serbia

    Olivera Markovic

  4. Clinic for Oncology, Clinical Centre Nis, Nis, Serbia

    Ivan Petkovic

  5. Department of Histopathology, Clinical Centre of Serbia, Belgrade, Serbia

    Maja Perunicic Jovanovic

  6. Department of Statistics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Goran Trajkovic

Authors
  1. Biljana Mihaljevic
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  2. Jelena Jelicic
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  3. Bosko Andjelic
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  4. Darko Antic
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  5. Olivera Markovic
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  7. Maja Perunicic Jovanovic
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  8. Goran Trajkovic
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  9. Jelena Bila
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  10. Vladislava Djurasinovic
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  11. Aleksandra Sretenovic
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  12. Vojin Vukovic
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  13. Mihailo Smiljanic
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  14. Milena Todorovic Balint
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Correspondence to Biljana Mihaljevic.

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Mihaljevic, B., Jelicic, J., Andjelic, B. et al. FCG (FLIPI, Charlson comorbidity index, and histological grade) score is superior to FLIPI in advanced follicular lymphoma. Int J Hematol 104, 692–699 (2016). https://doi.org/10.1007/s12185-016-2099-7

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  • DOI: https://doi.org/10.1007/s12185-016-2099-7

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