Follicular Lymphoma (FL) is a type of blood cancer and a form of non-Hodgkin's lymphoma. Thanks to new treatment breakthroughs, about 80% of FL patients have a survival rate of more than 10 years. The other 20%, however, experience a quickly recurring or a more aggressive version.
Researchers from the University of Missouri School of Medicine may have found a way to identify the patients at risk of recurrence, without the need for imaging and surveillance testing.
"We found over 10 genetic or molecular markers unique to patients whose FL cancer relapsed early," study author Cherian Verghese said. "These biomarkers are usually genetic mutations, and our data suggests they can be detected as early as at the time of diagnosis."
Verghese and his team looked at the genetic and molecular data of relapsed FL patients over a 14-year time span, from 2009 to 2023. Some of the markers have been used in past prognostic models that also tried to identify patients in the at-risk population, but many of these models had limitations.
"These limitations include the use of less reliable clinical predictors of relapse, like cancer stage or tumor grade," Verghese said. "Specific genetic mutations within these cancers appear to be better in predicting relapse than these other predictors. It's possible that these mutations give exceptional survival advantages to certain cancer cells, making relapses happen."
Being able to identify the patients prone to an early relapse can improve their outcomes and reduce excessive imaging for other patients with FL. As a result, this can lower costs and save time for both the patient and the hospital.
"Cancer is a devastating diagnosis. Patients will undergo what can feel like countless tests and scans, in addition to long courses of treatment," Verghese said. "Being able to determine who might relapse early can help us individualize cancer care to each person's needs, potentially reducing the number of tests needed while still prioritizing patient outcomes."
Cherian Verghese, MD, MPH is an associate professor of medicine at the Mizzou School of Medicine, and a hematologist-oncologist at MU Health Care. He is also the Charles R. and Veta G. Claiborn Distinguished Faculty Scholar in Cancer Research.
"Surveillance Strategies in Follicular Non-Hodgkin's Lymphoma's Using Molecular and Genetic Markers Improve Cost-efficiencies Over Routine Imaging Studies" was recently published in the American Journal of Clinical Oncology. In addition to Verghese, Mizzou study authors include fellows Urja Nagadia, MD and Niravkumar Brahmbhatt, MD. Kapil Meleveedu, MD; Raj Renju, MD; Arindam Bagchi, MD; Wael Ghalayini, MD; and Nebu Koshy, MD contributed.
