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Blood, 1 September 2006, Vol. 108, No. 5, pp. 1504-1508.
Prepublished online as a Blood First Edition Paper on May 11, 2006; DOI 10.1182/blood-2006-01-013367.
Previous Article | Next Article 
Submitted January 17, 2006
Accepted April 19, 2006
The Follicular Lymphoma International Prognostic Index
(FLIPI) separates high risk from intermediate or low
risk patients with advanced stage follicular lymphoma
treated front-line with Rituximab and the combination of
Cyclophosphamide, Doxorubicin, Vincristine and
Prednisone (R-CHOP) with respect to treatment outcome
Christian Buske*, Eva Hoster, Martin Dreyling, Joerg Hasford, Michael Unterhalt, and Wolfgang Hiddemann
Department of Internal Medicine III, Klinikum GroBhadern, University of Munich
Institute of Medical Informatics, Biometry and Epidemiology, University of Munich
* Corresponding author; email: buske{at}gsf.de.
The Follicular Lymphoma International Prognostic Index
(FLIPI) was developed to predict prognosis of patients
with follicular lymphoma (FL). However, it was based on
different protocols, none of which included Rituximab.
The current analysis aimed at evaluating the predictive
value of the FLIPI for treatment outcome in 362 patients
with advanced stage FL treated front-line with
Rituximab/CHOP in a prospective trial of the German Low
Grade Lymphoma Study Group. According to the FLIPI, 14%
of the patients were classified as low risk, 41% as
intermediate risk and 45% as high risk patients. With a
2-year time to treatment failure (TTF) of 67%, high risk
patients had a significantly shorter TTF as compared to
low or intermediate risk patients (2-year TTF of 92% and
90%, respectively; p = 0.0002). Our data demonstrate
that the FLIPI is able to identify high risk patients
with advanced stage FL after first-line treatment with
Rituximab/chemotherapy.

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