ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2026
FLIPI24: A Modern Prognostic Model and Clinical Trial Enrichment Tool for Newly Diagnosed Follicular Lymphoma.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- A deep learning PET/CT biomarker for early progression (POD24) and survival stratification in follicular lymphoma: a multicenter study.European journal of nuclear medicine and molecular imaging · 2026Article
- Chemotherapy-Sparing Strategies in Follicular Lymphoma: Emerging Targeted and Immune-Based Approaches.European journal of haematology · 2026Review
- Baseline systemic immune-inflammation index and a novel FLIPI-SII model predict POD24 and long-term survival in grade 1-3a follicular lymphoma.Frontiers in immunology · 2026Article
- Commentary: Baseline systemic immune-inflammation index and a novel FLIPI-SII model predict POD24 and long-term survival in grade 1-3a follicular lymphoma.Frontiers in immunology · 2026Article
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48 authors.
Funding
Abstract
purposeAlthough most patients with follicular lymphoma (FL) can expect an indolent course, progressive lymphoma remains the primary cause of death during the first decade after diagnosis. Progression of disease within 24 months (POD24) of starting first-line (1L) immunochemotherapy defines a high-risk population with poor survival, but better risk stratification at diagnosis is needed.
methodsThe FLIPI24 model was developed and internally validated to predict 24-month event rates using individual data from 4,485 patients treated with 1L immunochemotherapy from 10 observational cohorts of FL. Overall and cause-specific survival was further evaluated in FLIPI24 risk groups. External validation in the 1L immunochemotherapy setting was performed using the prospective observational Lymphoma Epidemiology of Outcomes (LEO) cohort (N = 565) and three randomized phase III trials (N = 3,192); extension to all patients with FL (any 1L therapy) was performed in the LEO cohort (N = 1,445) and its Molecular Epidemiology Resource subcohort (N = 1,074).
resultsThe FLIPI24 model uses age and four blood-based variables (hemoglobin, lactate dehydrogenase, beta-2 microglobulin, and WBC count). FLIPI24 showed consistent performance across validation and extension data sets, which was superior to existing prognostic tools. Across the four external immunochemotherapy validation data sets, patients with high-risk FLIPI24 (23%-32% of patients) had significantly higher 24-month event rates (22%-35%) and inferior 5-year overall survival (77%-83%) compared with patients with low-risk FLIPI24 (29%-31% of patients, 24-month event rates: 10%-12%; 5-year OS: 96%-97%). Results were consistent when evaluating lymphoma-related death and when extended to all patients with FL.
conclusionThe FLIPI24 model robustly stratifies, at diagnosis, patients with FL at increased risk of lymphoma-related death versus patients with very low lymphoma-related mortality during the first decade after diagnosis. FLIPI24 can be used to enrich future clinical trial designs in newly diagnosed FL.
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