{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:27:28Z","timestamp":1787761648329,"version":"build-2784847793"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018537","name":"National Science and Technology Major Project","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018537","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Follicular lymphoma (FL) exhibits substantial clinical heterogeneity, and progression of disease within 24 months (POD24) represents a critical adverse clinical endpoint. Traditional prognostic models rely predominantly on tumor-related parameters and overlook systemic immune-inflammatory status. The newly established FLIPI24 index emphasizes peripheral blood markers but lacks immune-related indicators. Here, we investigated the prognostic value of the baseline systemic immune-inflammation index (SII) and developed a novel FLIPI-SII model to improve risk stratification in patients with grade 1\u20133a FL. A total of 628 patients were used for model training\/internal validation, and 187 R-CHOP-treated patients for external validation. High SII (&amp;gt;580) was significantly correlated with inferior overall survival (OS) and progression-free survival (PFS), and was identified as an independent prognostic risk factor in multivariate regression analysis. The predictive efficacy of SII remained stable in patients receiving rituximab-based immunochemotherapy. We further constructed a 6-item FLIPI-SII scoring system, which categorized patients into four distinct risk subgroups and exerted powerful predictive performance for POD24. The model effectively predicted both PFS and OS in our cohort and was validated in two external centers. The FLIPI-SII model presented higher C-index values than conventional FLIPI, FLIPI2, and PRIMPI for both OS and PFS prediction. In conclusion, baseline SII acts as a stable, non-invasive, and independent prognostic biomarker for grade 1\u20133a FL. The newly developed FLIPI-SII model greatly improves the prediction of POD24 and long-term survival, providing a reliable immune-associated tool for individualized clinical risk assessment.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1869187","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:37:20Z","timestamp":1784785040000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Baseline systemic immune-inflammation index and a novel FLIPI-SII model predict POD24 and long-term survival in grade 1\u20133a follicular lymphoma"],"prefix":"10.3389","volume":"17","author":[{"given":"Jingwei","family":"Yu","sequence":"first","affiliation":[{"name":"State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine\/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin\u2019s Clinical Research 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganggang","family":"Wang","sequence":"additional","affiliation":[{"name":"Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiesong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Lymphoma & Head and Neck Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanfang","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine\/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin\u2019s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Qiu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine\/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin\u2019s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengzi","family":"Qian","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine\/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical 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