Leukemic phase follicular lymphoma in a young adult

Rivera, Daniel; Wang, Wei; Aljumaili, Z; Hu, Zhihong

doi:10.1002/jcla.24869

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…Previous studies looking at CL in FL were either case reports or retrospective studies done prior to the broader adoption of BR chemotherapy (Table S5). 5–9 Of these, only one study 6 reported absolute CL cells with a median of 1.95 and showed >4 × 10 9 /L absolute PB CL cells was the most significant predictor for a shorter time to progression. Contrary to our findings, these studies suggest leukemic phase FL was associated with inferior PFS.…”

Section: Discussionmentioning

confidence: 99%

“…4 The relevance of CL in FL has previously been evaluated with mixed results. [5][6][7][8][9] Therefore, we sought to explore the prognostic relevance of CL at diagnosis in patients with newly diagnosed FL in the contemporaneous era.…”

Section: Introductionmentioning

confidence: 99%

“…Patients with FL can present with circulating lymphoma (CL) cells at diagnosis, which can be an indication for treatment depending on the level (>5 × 10 9 /L) 4 . The relevance of CL in FL has previously been evaluated with mixed results 5–9 . Therefore, we sought to explore the prognostic relevance of CL at diagnosis in patients with newly diagnosed FL in the contemporaneous era.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic relevance of circulating lymphoma cells at diagnosis in newly diagnosed follicular lymphoma patients

Annunzio,

Bhatta,

Hanel

et al. 2024

Hematological Oncology

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Follicular lymphoma (FL) is the most common indolent B‐cell non‐Hodgkin lymphoma. Circulating lymphoma (CL) cells can be seen at diagnosis in some FL patients, however, previous studies evaluating this have shown mixed results. Therefore, we sought to evaluate the impact of CL at diagnosis on outcomes in patients with newly diagnosed FL using data from a single center. Patients were divided into CL+ and CL− based on immunophenotyping via peripheral blood (PB) flow cytometry. CL was defined as detectable clonally restricted B‐cells that matched the actual or expected B‐cell immunophenotype of FL. The primary endpoint was progression‐free survival (PFS) after first‐line treatment and secondary endpoints included overall response rate (ORR), overall survival (OS), diagnosis to treatment interval (DTI), progression of disease within 2 years of diagnosis (POD24), and cumulative incidence of transformation between the two groups. Among the 541 patients with FL, 204 had PB flow cytometry performed at diagnosis, and after excluding patients not meeting the eligibility criteria, 147 cases remained with 24 (16%) CL+ at diagnosis. Patients in the CL+ group were younger (53 vs. 58 years, p = 0.02), had more extranodal involvement (83% vs. 44%, p < 0.01), follicular lymphoma international prognostic index 3–5 (55% vs. 31%, p = 0.01), and a higher proportion received first‐line immunochemotherapy (75% vs. 43%, p = 0.01) compared to the CL−group. The median PFS was not significantly different between CL+ (6.27 years, 95% CI = 3.61‐NR) and CL− (6.61 years, 95% CI = 5.10–9.82) cohorts regardless of the first‐line treatment or level of absolute PB CL cells. There was no significant difference in ORR, median OS, DTI, POD24, and cumulative incidence of transformation between the two groups. In our study, we found that the presence of CL cells at diagnosis in FL in the contemporary era did not impact outcomes and survival.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic relevance of circulating lymphoma cells at diagnosis in newly diagnosed follicular lymphoma patients

Annunzio,

Bhatta,

Hanel

et al. 2024

Hematological Oncology

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Leukemic phase follicular lymphoma in a young adult

Rivera

Wang

Aljumaili

et al. 2023

Clinical Laboratory Analysis

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Background Leukemic presentation of follicular lymphoma (FL) is uncommon, with most cases reported in older adults. Design This report describes an unusual case of a young adult diagnosed with leukemic phase of FL. We reviewed the existing literature on this rare presentation of the disease and its potential impact on patient outcomes. Results Leukemic phase of FL in young adults can be mistaken for other high‐grade hematologic malignancies. Morphology assessment and ancillary testing, such as flow cytometry and FISH analysis, can assist in achieving an accurate diagnosis of the leukemic phase of FL. Notably, our young patient responded well to therapy, which is different from what is typically observed in older patients who have a poorer prognosis. Further cases are needed to investigate the prognostic impact of the leukemic phase of FL in younger patients.

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