Scientists at the National Cancer Institute (NCI), part of the National Institutes of Health, have created a model that predicts the survival of follicular lymphoma patients based on the molecular characteristics of their tumors at diagnosis. The model is based on two sets of genes--called survival-associated signatures--whose activity was found to be associated with good or poor prognosis for patients with the cancer. The scientists results, to be published in the November 19, 2004, New England Journal of Medicine*, suggest that immune cells infiltrating follicular lymphoma tumors have an important impact on survival--both signatures came from such immune cells.
The progression rate of follicular lymphoma, the most common non-Hodgkin lymphoma, varies widely. "In some patients the disease progresses slowly over many years, whereas in others progression is rapid, with the cancer transforming into aggressive lymphoma and leading to early death," explained principle investigator Louis M. Staudt, M.D., Ph.D., of NCIs Center for Cancer Research. "Understanding the molecular causes of such differences in survival could provide a more accurate method to determine patient risk, which could be used to guide treatment and may suggest new therapeutic approaches."
To create their model, Staudt and associates used follicular lymphoma biopsies taken from 191 untreated patients. The biopsies were taken between 1974 and 2001 and came from North American and European institutions that are part of the NCI-sponsored Lymphoma/Leukemia Molecular Profiling Project**. Following their biopsies, all patients received standard treatments. The NCI scientists examined their subsequent medical records to determine survival. Biopsies were divided into two groups balanced for survival and institution: 95 went into a group used to uncover gene expression patterns associated with survival; the other 95 were used to test the predictive power of these patterns.
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