970P - Modeling the epidemiology of folicular lymphoma (FL) in France

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Lymphomas
Aetiology, Epidemiology, Screening and Prevention
Basic Scientific Principles
Presenter Philippe Solal Céligny
Citation Annals of Oncology (2014) 25 (suppl_4): iv327-iv339. 10.1093/annonc/mdu339
Authors P. Solal Céligny1, A. Herrera2, E. Cornet3, X.G. Troussard4
  • 1Hématologie, ICO Paul Papin, 49933 - Angers/FR
  • 2Médecine Interne Immunologie, Hopital Antoine Béclère, 92140 - Clamart/FR
  • 3Laboratoire D'hématologie, Hôpital Cote de Nacre, 14033 - CAEN/FR
  • 4Hématologie, Hôpital Cote de Nacre, 14033 - CAEN/FR



As of 2014, there were few reliable publication sources of epidemiology data for follicular lymphoma in France, particularly as it pertains to advanced stage, relapsed patients. Epidemiology registries provide useful data on disease incidence but no information can be directly obtained for treatment relapse. To address this gap we undertook an innovative modeling approach. The objective of the model was to determine the yearly incidence of first line and later lines of therapy patients from 2014 to 2019.


First, we used the “Registre Régional des Hémopathies Malignes de Basse-Normandie” (RRHMBN) to collect real-world patient characteristics, such as tumor staging and Follicular Lymphoma International Prognostic Index (FLIPI) scoring. Then we applied these data to the French National Network of Registers “FRANCIM” incidence and survival data. Finally, we applied data from medical literature to progression free survival (PFS) for each standard of care treatment into the epidemiological model. 36% of patients were classified FLIPI 0-1 and 60% of them had a stage I or II and were not treated. 90% of stages III/IV were treated by Rituximab alone (R) regimen with a PFS equal to 26 months. Others stages III/IV and 90% of FLIPI ≥ 2 were treated with Rituximab (R) – Cyclophosphamide (C) – Hydroxydaunorubicin (H) – Vincristine (O) – Prednisone (P) regimen with a PFS equal to 42.2 months. For the 10% FLIPI ≥ 2, Rituximab (R) – Cyclophosphamide (C) – Vincristine (O) – Prednisone (P) regimen with a PFS equal to 34 months was used.


The table below shows a summary of the yearly incidence of patients eligible for treatments in first or further line as produced by our model.

2014 2015 2016 2017 2018 2019
Pts in 1st line (L) 353 367 380 395 409 425
Pts in ≥ 2nd L 267 279 291 299 304 304
TOTAL STAGE I/II 620 646 671 694 713 729
Pts in 1st L 1783 1850 1919 1991 2067 2144
Pts in ≥ 2nd L 1161 1235 1286 1336 1391 1437
TOTAL STAGE III / IV 2944 3085 3205 3327 3458 3581


Our modeling approach compensates for a lack of real-world information on relapsed follicular lymphoma. We have shown that there is a significant number of relapsed patients who are in need of new treatments. This novel approach to modeling provides a basis for subsequent economic modeling of relapsed disease.


All authors have declared no conflicts of interest.