Abstract
Purpose Follicular lymphoma (FL) is common subtype of indolent non-Hodgkin's lymphoma (NHL). However, there is no consensus on the management of FL grade 3A (FL3A). Methods We performed a real-world study of newly diagnosed FL patients from January 2013 to December 2022. we collected the clinical data of FL3A patients to analyse the correlation among baseline features, therapy regimens and prognosis. The data were collected from the hospital's electronic medical records system. Results A total of 223 patients with FL3A were enrolled. With a median follow-up of 41 months, the expected 5-year overall survival (OS) was 97.4% and the 5-year progression-free survival (PFS) was 73%. In real-word, most patients with advanced FL3A in low-tumor-load received therapy, majority with RCHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). Patients with advanced FL3A treated with RCHOP regimen and maintenance therapy had better PFS. There was no significant difference in PFS between the treatment group and watch-and-wait group in patients with low-tumor-load. The univariate analyses indicated that the maximum 18FFluorodeoxyglucose uptake in PET (SUVmax), Ki-67 index, platelet count were related to prognosis. Multivariate analyses showed that only SUVmax was the independent prognostic factor and SUVmax ≥ 15 related with poor PFS. Conclusion FL3A patients have a long survival, with a 5-year PFS of 73%. In real-world, most patients with advanced FL3A in low-tumor-load received therapy. Multivariate analyses indicated that SUVmax ≥ 15 was an independent poor prognostic factor affecting PFS in patients with advanced FL3A. In addition, Ki-67 index was also maybe related with prognosis.