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Early Progression As a Predictor of Survival in Marginal Zone Lymphomas: An Analysis from the FIL-NF10 Study

Stefano Luminari, Michele Merli, Sara Rattotti, Vittoria Tarantino, Luigi Marcheselli, Federica Cavallo, Marzia Varettoni, Benedetta Bianchi, Francesco Merli, Alessandra Tedeschi, Giuseppina Cabras, Francesca Re, Carlo Visco, Marcia Torresan Delamain, Emanuele Cencini, Michele Spina, Simone Ferrero, Angela Ferrari, Marina Deodato, Donato Mannina, Ombretta Annibali, Angela Rago, Lorella Orsucci, Irene Defrancesco, Marco Frigeni, Marina Cesaretti and Luca Arcaini

Key Points

  • Patients with MZL who experience PD within 24 months from initial systemic therapy (POD24) have a significant increase of the risk of Death.

  • Association of POD24 with survival is confirmed for the main MZL subtypes

Abstract

Marginal zone Lymphomas (MZL) are indolent B cell non Hodgkin Lymphoma (INFL) and have a heterogeneous clinical behavior. Recently time to progression shorter than 24 months (POD24) was identified to stratify overall survival (OS) in follicular NHL and in INFL. Here we examined the ability of POD24 to predict subsequent OS in a large, international cohort of MZL as part of the NF10 prospective international registry (NCT02904577) headed by Fondazione Italiana Linfomi (FIL). POD24 was calculated only for MZL patients requiring immediate therapy and was defined as experiencing lymphoma progression within 24 months from diagnosis. Among the 1,325 patients enrolled in the NF10 study we identified 321 pts with MZL for whom immediate therapy was planned right after lymphoma diagnosis. Overall POD24 was confirmed in 59 patients (18%). Three-year OS for patients with POD24 was 53% with a HR of 19.5 (95%CI 8.4-45) compared with patients without POD24 (3 yr OS 95%). Association of POD24 with OS was confirmed for the subgroup of splenic and extranodal MZL. Assessment of POD24 stratifies subsequent outcome in MZL and identifies high risk population.

  • Submitted February 25, 2019.
  • Revision received July 10, 2019.
  • Accepted June 25, 2019.