Impact of treatment in long-term survival patients with follicular lymphoma: A Spanish Lymphoma Oncology Group registry

Abstract

BackgroundFollicular lymphoma is the second most common non-Hodgkin lymphoma in the United States and Europe. However, most of the prospective randomized studies have very little follow-up compared to the long natural history of the disease. The primary aim of this study was to investigate the long-term survival of our series of patients with follicular lymphoma.Patients and methodsA total of 1074 patients with newly diagnosed FL were enrolled. Patients diagnosed were prospectively enrolled from 1980 to 2013.ResultsMedian follow-up was 54.9 months and median overall survival is over 20 years in our series. We analyzed the patients who are still alive beyond 10 years from diagnosis in order to fully assess the prognostic factors that condition this group. Out of 166 patients who are still alive after more than 10 years of follow-up, 118 of them (73%) are free of evident clinical disease. Variables significantly associated with survival at 10 years were stage < II (p <0.03), age < 60 years (p <0.0001), low FLIPI (p <0.002), normal β2 microglobulin (p <0.005), no B symptoms upon diagnosis (p <0.02), Performance Status 0–1 (p <0.03) and treatment with anthracyclines and rituximab (p <0.001), or rituximab (p <0.0001).ConclusionsA longer follow-up and a large series demonstrated a substantial population of patients with follicular lymphoma free of disease for more than 10 years.

Transformed follicular lymphoma in the rituximab era: A report from the Spanish Lymphoma Oncology Group

“…Regarding the option of “watch and wait,” there is no consensus in any series regarding the number of patients that are candidates to this therapeutic option . In our series, we have a clearly lower rate than others previously published . There is some controversy regarding the possible correlation between “watch and wait” and HT.…”

“…13 HT occurrence is 2% to 3% patients per year. 2,14,15 Three studies have been performed in the era of immunochemotherapy, 7,9,14 describing that the rate of transformation was close to 10%. We have recorded a cumulative incidence of transformation at 5 years of 7.3%.…”

“…6,7 The importance of studying HT relies in the fact that while the clinical course of FL tends to be indolent for decades, when an HT occurs, the expected survival may decrease to approximately 2 years. 8,9 Although this process was first described more than 70 years ago by Gall and Mallory, 10 its biological process and clinical events remain unknown. 11 Many important issues remain unanswered, such as its actual incidence, how to predict it, or which drugs can improve its survival.…”

Axicabtagene ciloleucel, a first-in-class CAR T cell therapy for aggressive NHL

“…TFL is an aggressive form of the generally indolent follicular lymphoma (FL) that develops in 2-3% of FL cases per year [16]. Although the median overall survival (OS) of FL is 15 to >20 years [17,18], the median OS of TFL is poor, ranging from 2.5 months to 2.5 years [14]. PMBCL constitutes 2-4% of NHL cases [15] and is also associated with poor outcomes [15,19].…”

Front‐line management of non‐Hodgkin lymphoma in Australia. Part 1: follicular lymphoma

“…The more recent FLIPI2 was developed prospectively in newly diagnosed patients commencing systemic therapy in the rituximab era and is thus a more relevant prognostic tool in such patients, with added parameters (Table ) . The FLIPI remains prognostic, however, in the rituximab era, with 5 and 10‐year follow‐up data and is widely used in clinical practice. There have been no direct comparisons between the two but, as has been noted in a pooled analysis, only FLIPI2 remained prognostic in the context of end‐of‐induction PET‐CT status .…”