Improvement of Overall and Failure-Free Survival in Stage IV Follicular Lymphoma: 25 Years of Treatment Experience at The University of Texas M.D. Anderson Cancer Center

Liu, Qi; Fayad, Luis; Cabanillas, Fernando; Hagemeister, Fredrick B.; Ayers, Gregory D.; Hess, Mark A.; Romaguera, Jorge; Rodriguez, Maria Alma; Tsimberidou, Apostolia M.; Verstovšek, Srđan; Younes, Anas; Pro, Barbara; Lee, Ming Sheng; Ayala, Ana; McLaughlin, Peter

doi:10.1200/jco.2005.03.3696

Cited by 183 publications

(112 citation statements)

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“…With advances in medical care, particularly with effective chemotherapy, patients with NHL can now live much longer. This survival benefit, documented in numerous clinical trials, [8][9][10][11][12][13][14][15][16][17][18][19][20] has been translated into the community effectiveness according to our population-based study. Patients receiving chemotherapy had a significantly lower risk of death.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The incidence of NHL has been increasing over the last several decades worldwide, [1][2][3][4][5][6][7] and Caucasians have higher incidence and mortality rates of NHL than patients in other ethnic groups. 1,2,5 During this period of time, treatment has improved, particularly with com-bination chemotherapy CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) [8][9][10][11][12][13][14][15][16] and later with the addition of rituximab to CHOP for Bcell NHL since 1998. [17][18][19][20] Although there were several studies that demonstrated ethnic disparities in receiving these treatments, [21][22][23] none of these studies has specifically addressed ethnic disparities in survival and whether these survival differences were due to disparities in treatment, diagnosis, or socioeconomic status (SES) or to other factors in patients with NHL.…”

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confidence: 99%

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Ethnic variations in diagnosis, treatment, socioeconomic status, and survival in a large population‐based cohort of elderly patients with non‐Hodgkin lymphoma

Wang

Burau

Fang

et al. 2008

Cancer

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BACKGROUND.There is a lack of research on ethnic disparities in survival among patients with non‐Hodgkin lymphoma (NHL), although these disparities have been documented for patients with many other tumors.METHODS.A retrospective cohort of 13,321 patients diagnosed with incident NHL at age ≥65 years from 1992 to 1999 were identified from the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database with 11 years of follow‐up. Of these patients, 11,868 were Caucasians, 533 were African Americans, and 920 were other ethnicities. A time‐to‐event Cox regression model was used to examine the relative risk of all‐cause and disease‐specific mortality.RESULTS.A larger proportion (72.2%) of African Americans were in the poorest quartile of socioeconomic status as measured by the poverty level compared with 21.8% of Caucasians, and 43.2% of African Americans received chemotherapy compared with 52.4% of Caucasians (P < .01). Hazard ratio of all‐cause and NHL‐specific mortality increased significantly with age, advanced stage, higher comorbidity scores, and poorer socioeconomic status. Patients receiving either chemotherapy or radiotherapy or both were significantly less likely to die. After taking into account differences in treatment, comorbidity, and socioeconomic status, there was no statistically significant difference in the risk of all‐cause (hazard ratio, 0.97; 95% confidence interval, 0.88‐1.08) and disease‐specific mortality (hazard ratio, 1.07; 95% confidence interval, 0.92‐1.25) between African Americans and Caucasians.CONCLUSIONS.The risk of mortality in patients with NHL was associated with socioeconomic status and was reduced in patients receiving chemotherapy. No significant differences in the risk of mortality were observed between African Americans and Caucasians after controlling for factors such as treatment and socioeconomic status. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Ethnic variations in diagnosis, treatment, socioeconomic status, and survival in a large population‐based cohort of elderly patients with non‐Hodgkin lymphoma

Wang

Burau

Fang

et al. 2008

Cancer

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“…9 The median FFS ranged from 4.1 to 4.8 years, with a significant subset of patients (33%-44%) in remission at 15 years. 10 The nucleoside analog fludarabine used alone or in combination is highly active in FL. Based on encouraging results with fludarabine, mitoxantrone, and dexamethasone (FND) in relapsed FL, we conducted a randomized study to compare FND with ATT.…”

Section: A Short History Of Chemotherapy In Follicular Lymphomamentioning

confidence: 99%

“…Nearly every aforementioned regimen will result in a subset of patients who attain a molecular response and achieve durable remissions. 10 Long-term follow-up of several studies suggest that~30% to 40% of patients will not experience relapse despite decades of follow-up. 2,9,10 Furthermore, the rate of relapse appears to plateau between 8 and 10 years in most trials.…”

Section: A Short History Of Chemotherapy In Follicular Lymphomamentioning

confidence: 99%

“…11 Despite significant toxicity, long-term follow-up again demonstrated~40% of patients who remained in persistent remission at 10 years. 10 The first and only agent to repeatedly confer a survival advantage when added to chemotherapy in FL is the biological agent rituximab. Unlike traditional chemotherapy, direct cytotoxicity is only a minor action of this immunotherapeutic, and the ability to augment antibodymediated cellular cytotoxicity (ADCC) likely explains its high level of activity in FL.…”

Section: A Short History Of Chemotherapy In Follicular Lymphomamentioning

confidence: 99%

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Frontline strategy for follicular lymphoma: are we ready to abandon chemotherapy?

Fowler

2016

Hematology

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Chemotherapy combinations have been the backbone of therapy for follicular lymphoma, and are associated with high initial response rates. Unfortunately, toxicity and secondary malignancies remain concerns, and most advanced-stage patients still relapse within 5 years, regardless of the regimen. Advances in the understanding of lymphoma biology have resulted in a new generation of noncytotoxic therapeutics with significant activity in follicular lymphoma. Recent studies exploring biological and targeted combinations in the frontline have shown promise, with response rates similar to chemotherapy. However, these regimens are also associated with significant cost as well as a unique toxicity profile. Large randomized studies are underway to compare noncytotoxic regimens with chemotherapy in the frontline, and several new combinations are being tested in the phase 2 setting. Ongoing work to identify predictive biomarkers and investment in mechanistic studies will ultimately lead to the personalization of therapy in the frontline setting for follicular lymphoma. Learning Objectives• To describe the evolution of standard frontline therapy in follicular lymphoma and the outcomes associated with common cytotoxic regimens • To understand the rationale for emerging noncytotoxic combinations and the activity of several regimens currently under study

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Chemotherapy plus Rituximab versus chemotherapy alone for B-cell non-Hodgkin's lymphoma

Schulz

Bohlius

Skoetz

et al. 2007

Cochrane Database of Systematic Reviews

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Improvement of Overall and Failure-Free Survival in Stage IV Follicular Lymphoma: 25 Years of Treatment Experience at The University of Texas M.D. Anderson Cancer Center

Cited by 183 publications

References 26 publications

Ethnic variations in diagnosis, treatment, socioeconomic status, and survival in a large population‐based cohort of elderly patients with non‐Hodgkin lymphoma

Ethnic variations in diagnosis, treatment, socioeconomic status, and survival in a large population‐based cohort of elderly patients with non‐Hodgkin lymphoma

Frontline strategy for follicular lymphoma: are we ready to abandon chemotherapy?

Chemotherapy plus Rituximab versus chemotherapy alone for B-cell non-Hodgkin's lymphoma

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