Few investigations have quantified the observed survival in patients with follicular lymphoma (FL) compared with those expected in the general population. For one thing, this disease presents a median survival of approximately 10 years and is considered incurable, many treatments have been incorporated to this disease and hence our interest in studying its influence in overall survival compared with the general population.
We reviewed 1074 patients treated and diagnosed with FL who were included in the Follicular Lymphoma Registry, a prospective registry that includes all new lymphoma cases, regardless of their histological subtype. Standardized mortality ratios (SMRs) were obtained for 1074 patients with Follicular non-Hodgkin Lymphoma, from 1980 to 2013.
The overall survival rates were 234 months (95% CI: 212-255). The overall standardized mortality ratio (SMR) of cancer patients was, including all death causes, 2.54 (95% CI: 2.22-2.90), being higher for women, with an SMR of 3.04 (95% CI: 2.51-3.69) and in young adults 5.55 (95% CI: 2.89-10.66) in patients under 40, whereas in patients over 60 it was 2.14 (95% CI: 1.82-2.52). After 10 years from diagnosis, the FL mortality rate becomes lower than in the general population (SMR 0.46, 95% CI: 0.28-0.77). Excluding FL as a cause of death, the overall SMR was 1.14 (95% CI: 0.93 to 1.38). None of the age segments studied showed a statistically significant mortality excess compared with the general population of the same age and gender. In the multivariable Cox analysis, rituximab is associated with a lower mortality rate compared with patients who did not receive it (HR 0.57. 95% CI 0.41 to 0.78, p = 0.001).
This is the first European population-based study, to our knowledge, to quantify short-term and long-term follicular lymphoma mortality after diagnosis, along with analyzing its mortality compared with the general population of the same sex and age. Our registry provides information concerning cause-specific long-term mortality among 5613 person-year survivors with follow-up for death extending from 1980 through 2013. Unlike other types of lymphoma, such as Hodgkin's lymphoma, non-tumor causes have little influence on the long-term mortality.
Clinical trial identification
Legal entity responsible for the study
Spanish Lymphoma Study Group (GOTEL)
All authors have declared no conflicts of interest.