ArticlePloS one2025
Risk and prognosis of second primary malignancies in patients with follicular lymphoma in the era of rituximab: A population study based on the SEER database.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFollicular lymphoma (FL) patients have achieved favorable long-term survival since the introduction of rituximab. However, the development of second primary malignancies (SPMs) indicates a poor survival prognosis for FL patients, and large-scale studies in this field remain limited. This study investigates the prognostic factors for FL patients in the rituximab era, as well as the clinical characteristics, risk factors, and prognosis for patients who developed SPMs.
methodsFrom 2000 to 2020, a total of 33,104 patients with pathologically confirmed FL were identified within the Surveillance, Epidemiology, and End Results (SEER) database. Competing-risk regression analysis was used to assess prognostic factors for lymphoma-specific survival (LSS), risk factors for developing SPMs, and prognosis in FL patients.
resultsMultivariate analysis identified age ≥ 40 years, Black race, unmarried status, non-urban residence, nodal lymphoma presentation, Grade 3 histology, advanced Ann Arbor stage, and B symptoms as independent adverse prognostic factors for both overall survival (OS) and LSS. Chemotherapy as initial treatment was associated with inferior LSS in FL patients. Protective factors for OS and LSS included female sex, higher income, diagnosis post-2005, diagnosis-to-treatment intervals >1 month, and receipt of radiotherapy or surgery. SPMs correlated with reduced LSS risk in FL patients. Elevated SPM incidence among patients aged>40years, and non-Hispanic ethnicity, while reduced SPM risks were observed in females, unmarried patients, those receiving non-radiotherapy initial treatment, Grade 3 cases, and patients diagnosed during 2015-2019. Notably, FL patients aged >60 years, unmarried, and those diagnosed post-2010 demonstrated heightened OS risk following SPM development. Conversely, initial radiotherapy conferred protective effects against both OS and LSS in patients with SPMs.
conclusionIn this study, we conducted a large, population-based analysis across the United States to identify risk factors for the development of SPMs and to delineate prognostic indicators for FL patients in the context of rituximab therapy, along with the clinical characteristics, risk factors, and prognostic features associated with SPMs. These findings have translational implications for risk-adapted surveillance. Future studies should validate predictive models across diverse healthcare settings, elucidate molecular mechanisms of SPM pathogenesis in FL, and evaluate targeted screening interventions through prospective trials.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.