{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:40:38Z","timestamp":1779316838686,"version":"3.51.4"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008395","name":"oktat\u00e1si \u00e9s kultur\u00e1lis miniszt\u00e9rium","doi-asserted-by":"publisher","award":["\u00daNKP-20-4"],"award-info":[{"award-number":["\u00daNKP-20-4"]}],"id":[{"id":"10.13039\/501100008395","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Follicular lymphoma (FL) is an indolent, yet heterogeneous, B-cell lymphoproliferative disorder. Although most FL patients respond well to treatment, few with specific traits have a poor prognosis; the latter are difficult to define.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Patients and methods<\/jats:title>\n<jats:p>We retrospectively analyzed data from 143 FL patients treated at the University of Debrecen since 2009 and investigated prognostic factors that may influence the survival of FL patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A maximum standardized uptake value (SUVmax) cut-off of 9.85 at the staging positron emission tomography\/computed tomography (PET\/CT) (p = 0.0001, hazard ratio [HR]: 0.2535, 95% confidence interval [CI]: 0.1118\u20130.4878) and a lymphocyte\/monocyte (Ly\/Mo) ratio of 3.41 (p = 0.0027, HR: 2.997, 95% CI: 1.463\u20136.142), drawn at diagnosis, significantly predicted FL patients\u2019 progression-free survival (PFS). A staging SUVmax &gt;9.85 with Ly\/Mo &lt;3.41 could delineate a high-risk group of FL patients (p&lt;0.0001, HR: 0.0957, 95% CI: 0.03416\u20130.2685). Similarly, a significant difference was shown with an SUVmax cut-off of 3.15 at the interim PET\/CT (p&lt;0.0001, HR: 0.1614, 95% CI: 0.06684\u20130.3897). A staging SUVmax &gt;9.85 in conjunction with interim SUVmax &gt;3.15 predicted poor prognosis (p&lt;0.0001, HR: 0.1037, 95% CI: 0.03811\u20130.2824). The PFS difference was translated into overall survival (OS) advantage (p = 0.0506, HR: 0.1187, 95% CI: 0.01401\u20131.005).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Biological prognostic factors, such as the Ly\/Mo ratio, may improve the prognostic assessment of staging PET\/CT. The survival advantage observed in PFS is translated into OS when determined using a combination of staging and interim SUVmax. We recommend investigating additional biological prognostic factors while highlighting the role of PET\/CT in FL.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0272787","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T17:48:26Z","timestamp":1659635306000},"page":"e0272787","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Clinical and biological prognostic factors in follicular lymphoma patients"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4181-4513","authenticated-orcid":true,"given":"\u00c1d\u00e1m","family":"J\u00f3na","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Kenyeres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e1ndor","family":"Barna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1rp\u00e1d","family":"Ill\u00e9s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zs\u00f3fia","family":"Simon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"issue":"48","key":"pone.0272787.ref001","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1093\/jncimonographs\/lgu006","article-title":"Medical history, lifestyle, family history, and occupational risk factors for follicular lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project","volume":"2014","author":"MS Linet","year":"2014","journal-title":"J Natl Cancer Inst Monogr"},{"key":"pone.0272787.ref002","doi-asserted-by":"crossref","first-page":"626035","DOI":"10.1155\/2012\/626035","article-title":"Exploring risk factors for follicular lymphoma.","volume":"2012","author":"AJ Ambinder","year":"2012","journal-title":"Adv Hematol"},{"issue":"9","key":"pone.0272787.ref003","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1038\/bjc.2015.94","article-title":"Lymphoma incidence, survival and prevalence 2004\u20132014: sub-type analyses from the UK\u2019s Haematological Malignancy Research Network","volume":"112","author":"A Smith","year":"2015","journal-title":"Br J Cancer"},{"issue":"6","key":"pone.0272787.ref004","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1182\/blood-2013-03-491514","article-title":"Improvements in observed and relative survival in follicular grade 1\u20132 lymphoma during 4 decades: the Stanford University experience","volume":"122","author":"D Tan","year":"2013","journal-title":"Blood"},{"issue":"27","key":"pone.0272787.ref005","first-page":"4555","article-title":"Follicular lymphoma international prognostic index 2: a new prognostic index for follicular lymphoma developed by the international follicular lymphoma prognostic factor project.","volume":"27","author":"M Federico","year":"2009","journal-title":"J Clin OncolEpub 2009 Aug 3"},{"issue":"3","key":"pone.0272787.ref006","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1200\/JCO.1997.15.3.1110","article-title":"Comparison in low-tumor-burden follicular lymphomas between an initial no-treatment policy, prednimustine, or interferon alfa: a randomized study from the Groupe d\u2019Etude des Lymphomes Folliculaires. 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