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Article / Publication Details
Abstract
Introduction: Follicular lymphoma (FL) is the most common type of indolent B cell lymphoma with a favorable prognosis in the majority of patients. The induction treatment is still based on rituximab and chemotherapy, though new anty-CD20 antibody and chemo-free regimen have been recently introduced. The aim of the study was to analyze the management, outcomes and determinants of prognosis of newly diagnosed patients with FL in real-world experience. Methods: Data of consecutive patients diagnosed with FL in 5 years period (2011 – 2015) in three oncohematoogical centers were reviewed. Variables were compared using Mann-Whitney or chi-squared test as appropriate, survival outpoints were calculated using Kaplan-Meier method. Results: One hundred eighty-one patients were included in the study. The median patients' age at diagnosis was 56.6 years. Low histological grade (G1-G2) was found in 62.1% of patients and advanced clinical stage in 77.0% of patients. ECOG 0 performance status was observed in 57.1% of patients. The median follow-up was 5.91 years. Initially, 31.5% of the patients were qualified to watch and wait strategy (W&W) and 84.0% of the whole patients' group received systemic treatment during the observation period. As induction treatment, 53.9% and 41.4% of patients received RCVP and RCHOP regimens, respectively; 39.8% received rituximab maintenance (RM) after first-line therapy. During follow-up, transformation to aggressive lymphoma occurred in 7.2% of patients. Median overall survival (OS) was not achieved, and median progression-free survival (PFS) was 8.28 years (95% CI; 7.35, NA), 19.6% of patients relapsed during 24 months from the start of the treatment (POD24). Median PFS for POD24 group was 1.1 years (95% CI; 0.56, 1.45) with a median OS longer than 8 years. ECOG 0, low PRIMAPI and no POD24 were found as determinants of longer PFS and OS. Conclusions: Our data from clinical practice showed that rituximab and chemotherapy is still an effective method of FL treatment resulting in survival more than 8 years from diagnosis in most patients. RCVP protocol followed with RM is a reasonable choice for the first-line therapy especially in low/intermediate group of patients. The prognosis was significantly worse in patients with POD24. Therefore, searching for precise initial clinical and biological markers is warranted and development therapies to improve prognosis of POD24 patients.
S. Karger AG, Basel
Article / Publication Details
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