Clinicopathological factors and tumor microenvironment markers predicting watch-and-wait discontinuation in 82 patients with follicular lymphoma

Objectives In this study, we aimed to determine the clinicopathological factors influencing the treatment-free period in patients with follicular lymphoma (FL) using a watch-and-wait (WW) strategy. Methods We retrospectively assessed histopathological parameters of 82 patients with FL. Results The median time from diagnosis to WW discontinuation was 62 months (range, 3-138), and median follow-up was 86 months (range, 3-183). Intermediate or high-risk Follicular Lymphoma International Prognostic Index score (P = .012), non-duodenal-type (P = .011), higher numbers of interfollicular CD4(+) (P = .038) and intrafollicular FOXP3(+) cells (P = .024) in the tumor microenvironment, and Ki-67 index >= 10% (P = .031) were significant adverse factors for WW discontinuation in univariate analyses. Conclusion Patients with adverse factors for WW discontinuation should be carefully observed during follow-up.