Pathologic Grade and Peripheral Blood NK Cell Percentage May Predict Outcomes Among Patients With Follicular Lymphoma
Key Clinical Summary
- Population and Design: Retrospective analysis of 118 Chinese patients with FL (median age 63 years; median follow-up 11.2 mo) evaluated pathologic grade and peripheral immune markers as prognostic factors.
- Efficacy: 2-year OS 90.1% and PFS 69.7%; CR rate 60.2%. Grade 3B or composite histology correlated with inferior PFS (HR 2.93; 95% CI, 1.08 to 7.96; P = .035); low NK cell percentage (<30%) predicted inferior OS (HR 0.067; 95% CI, 0.010 to 0.435; P = .005).
- Clinical Relevance: Pathologic grade and baseline NK cell levels may serve as independent prognostic biomarkers in FL, supporting further investigation of NK cell–targeted therapies alongside anti-CD20 agents.
Pathological grade and peripheral immune markers, including natural killer (NK) cell percentage, may serve as predictive markers for determining prognosis among patients with follicular lymphoma (FL), as well as provide insight into immune homeostasis and the tumor microenvironment, according to study results published in Annals of Hematology. This research supports further exploration of these potential prognostic markers.
Data has previously been limited on the clinical features and prognostic factors among patients with FL in China, to address this need, researchers conducted a retrospective analysis.
The primary outcomes were progression-free survival (PFS), defined as the time between initial treatment and relapse/death, and overall survival (OS), defined as the time from initial treatment to death of any cause.
Overall, 118 patients were included in the analysis. The median age of all patients was 63 years (range, 33 to 84). The median follow-up was 11.2 months (interquartile range [IQR], 8.4 to 12.0). The 2-year OS rate was 90.1% and the 2-year PFS rate was 69.7%. The complete response (CR) rate across the cohort was 60.2%.
Univariate analysis identified several clinicopathologic and immunologic features associated with inferior OS and/or PFS. Inferior PFS was associated with pathologic grade 3B or composite histology (P = 0.035; hazard ratio [HR]; 2.933; 95% confidence interval [CI], 1.080 to 7.963). Conversely, low NK cell percentage (<30%) was associated with inferior OS (P = 0.005;HR, 0.067; 95% CI, 0.010 to 0.435).
The researchers concluded, “The baseline peripheral blood NK cell count obtained at diagnosis may represent as an effective biomarker in clinical practice for host immune homeostasis and the tumor microenvironment in FL.”
They added, “These results support the potential interest of a treatment targeting the activation of NK cells, in particular, in new therapeutic designs including rituximab and obinutuzumab.”
Source:
Su Y, Hu Q, Zhao W, et al. Clinical features and prognosis analysis of patients with follicular lymphoma: a real-world study in China. Annals of Hematology. 2025;104(10):5257-5271. doi:https://doi.org/10.1007/s00277-025-06617-2
