Outcomes after R-CHOP in patients with newly diagnosed advanced follicular lymphoma: a 10-year follow-up analysis of the JCOG0203 trial

Watanabe, Takashi; Tobinai, Kensei; Wakabayashi, Masashi; Morishima, Yasuo; Kobayashi, Hirofumi; Kinoshita, Tomohiro; Suzuki, Takeshi; Yamaguchi, Motoko; Ando, Kiyoshi; Ogura, Michinori; Taniwaki, Masafumi; Uike, Naokuni; Yoshino, Tadashi; Nawano, Sigeru; Terauchi, Takashi; Hotta, Tomomitsu; Nagai, Hirokazu; Tsukasaki, Kunihiro; Kurosawa, Mitsutoshi; Yamagishi, Kayo; Kobayashi, Naoki; Minauchi, Koichiro; Harigae, Hideo; Fukuhara, Noriko; Takahashi, Naoto; Kameoka, Yoshihiro; Matsuda, Shin; Saitoh, Yuhji; Tsukamoto, Norifumi; Yokohama, Akihiko; Kubota, Nobuko; Minami, Yosuke; Yamauchi, Nobuhiko; Kumagai, Kyoya; Tsujimura, Hideki; Izutsu, Koji; Maruyama, Dai; Takayama, Nobuki; Ohyashiki, Kazuma; Akahane, Daigo; Shimoyama, Tatsu; Shimada, Takahiro; Kamiyama, Yutaro; Dobashi, Nobuaki; Wasada, Izumi; Sano, Fumiaki; Takimoto, Madoka; Chou, Takaaki; Ishiguro, Takanobu; Yasukawa, Masaki; Yamauchi, Takahiro; Ono, Takaaki; Yamamoto, Kazuhito; Kato, Harumi; Tokunaga, Takashi; Shimada, Kazuyuki; Ushijima, Yoko; Iida, Shinsuke; Kusumoto, Shigeru; Uchida, Toshiki; Hanamura, Ichiro; Kanasugi, Jo; Kagami, Yoshitoyo; Hiraga, Junji; Miyazaki, Kana; Utsumi, Takahiko; Kuroda, Junya; Kobayashi, Tsutomu; Matsumura, Itaru; Rai, Shinya; Murayama, Tohru; Gomyo, Hiroshi; Sunami, Kazutaka; Makita, Masanori; Ichinohe, Tatsuo; Fukushima, Noriyasu; Yoshida, Isao; Yakushijin, Yoshihiro; Asai, Hiroaki; Suehiro, Yutaka; Choi, Ilseung; Takamatsu, Yasushi; Sasaki, Hidetada; Yamasaki, Satoshi; Tsukada, Junichi; Morimoto, Hiroaki; Kimura, Shinya; Yokoo, Masako; Yoshida, Shinichiro; Moriuchi, Yukiyoshi; Miyazaki, Yasushi; Imaizumi, Yoshitaka; Jo, Tatsuro; Nosaka, Kisato; Tatetsu, Hiro; Hidaka, Masaaki; Harada, Naoko; Ohtsuka, Eiichi; Ishitsuka, Kenji; Yoshimitsu, Makoto; Utsunomiya, Atae; Takatsuka, Yuichi; Morishima, Satoko; Nakachi, Sawako

doi:10.1016/s2352-3026(18)30155-8

Cited by 20 publications

(23 citation statements)

References 31 publications

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“…However, racial disparities in the survival of FL have been proven in a comprehensive study, which showed that Asian/Pacific Islanders did not have improved 5‐year OS rates after R was used prevalently 13 . And research on the prognosis of FL was limited in Asia 26 . In our data, the clinical outcome was similar in patients whether they were treated with R or not.…”

Section: Discussionmentioning

confidence: 57%

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Prognostic significance of histologic grade and Ki‐67 proliferation index in follicular lymphoma

Xue

Yan

et al. 2020

Hematological Oncology

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The prognostic value of histologic grading and the Ki-67 proliferation index in follicular lymphoma (FL) is controversial. This study investigated the clinical usefulness of these two factors in Asian FL patients. Four hundred and thirty-three patients diagnosed with FL were retrospectively reviewed with a median follow-up time of 47.0 months (range, 24.0-168.0). The 10-year overall survival (OS) rate and progression-free survival (PFS) rate were 91.0% and 47.1%, respectively. Grade 3B and grade 3B with diffuse large B cell lymphoma (DLBCL) showed a better PFS than grade 1-3A (P < 0.001), and similar findings were noted in patients who received rituximab-containing regimens (P = 0.002). In contrast, no significant differences in terms of OS or PFS were observed between grades 1-2 and 3A. In addition, patients with Ki-67 ≥ 30% had a significantly better PFS than patients with Ki-67 < 30% (P = 0.014), although the difference was eliminated in the multivariate analysis. Both grade and Ki-67 index had no impact on prognosis in patients who did not receive rituximab treatment. In conclusion, grade 3A is closely related to grade 1-2, as reflected by a similar indolent clinical course and a lower PFS rate than grade 3B/3B + DLBCL. In addition, a higher Ki-67 index seems to have a positive effect on PFS in FL patients.

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Section: Discussionmentioning

confidence: 57%

“…13 And research on the prognosis of FL was limited in Asia. 26 In our data, the clinical outcome F I G U R E 5 Prognostic value of Ki-67 and correlation between Ki-67 and grade in FL patients. (A) PFS in the total cohort.…”

Section: Ki-67 Correlation With Outcome and Gradesmentioning

confidence: 69%

Prognostic significance of histologic grade and Ki‐67 proliferation index in follicular lymphoma

Xue

Yan

et al. 2020

Hematological Oncology

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“…Nevertheless, the authors brought forward several arguments to discuss potential etiologies. First, a suggested mechanism is the long-term immune dysfunction related to the lymphoma and its treatment [13,15,25,26,30], as lung [31][32][33][34] and skin cancer [28,35,36] occur more abundantly in immunosuppressed individuals.…”

Section: Discussionmentioning

confidence: 99%

The impact of prior malignancies on the development of second malignancies and survival in follicular lymphoma: A population‐based study

Dinnessen

Visser

Tonino

et al. 2020

eJHaem

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We assessed the impact of a prior malignancy diagnosis (PMD) – as a potential proxy for genetic cancer susceptibility – on the development of a second primary malignancy (SPM) and mortality in follicular lymphoma (FL) patients. From the nationwide Netherlands Cancer Registry, we selected all adult FL patients diagnosed in 1994‐2012 (n = 8028) and PMDs and SPMs relative to FL, with follow‐up until 2017. We constructed two Fine and Gray models – with death as a competing risk – to assess the association between a PMD and SPM incidence. A PMD was associated with an increased incidence of SPMs (subdistribution hazard ratio [SHR], 1.30; 95% confidence interval [CI], 1.03‐1.64) – especially carcinomas of the respiratory tract (SHR, 1.83; 95% CI, 1.10‐3.05) and cutaneous squamous cell carcinomas (SHR, 1.58; 95% CI, 1.01‐2.45) – and a higher risk of mortality in a multivariable model (HR, 1.43; 95% CI, 1.19‐1.71). However, when additionally adjusted for the receipt of systemic therapy and/or radiotherapy before FL diagnosis, only patients who received such therapies had an increased incidence of SPMs (SHR, 1.40; 95% CI, 1.02‐1.93). In conclusion, patients with a PMD had a higher rate of SPMs and mortality than those without a PMD, which might have resulted from therapy‐related carcinogenesis.

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“…Six RCTs were assessed as low risk in the light of a suitable option (Figure 2A and 2B). However, four of RCTs have a high risk of selection bias as Allocation concealment (14,16,18,21). All funnel plots of PFS and OS were symmetrical, indicating no publication bias( Figure 2C and 2D).…”

Section: Qualityassessmentmentioning

confidence: 96%

Therapy with of RCHOP-14 Versus RCHOP-21 for People With Aggressive or Advanced Stage Indolent B-Cell Non-Hodgkins Lymphoma: A Systematic Review and Meta-Analysis

He¹,

Tao²,

Ji³

et al. 2020

Preprint

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Background: With the advent of rituximab, RCHOP is considered the appropriate chemotherapy for aggressive or advanced stage indolent B-cell Non-Hodgkins Lymphoma(NHL). RCHOP-14 seems to achieve better outcomes than RCHOP -21 in aggressive or advanced stage indolent B-cell NHL patients in recent years.Methods: To verify the befitting chemotherapy regimens for B-cell NHL patients, we searched the electronic databases for relevant English-language literature published through January 2020. The primary outcomes were complete response(CR),progression-free survival (PFS), overall survival(OS), and Adverse events (AEs). Six eligible Phase II and III clinical randomized controlled trials (RCTs) and two high-quality observational comparative studies (OCSs)were extracted, and 5565 B-cell NHL patients involved in evaluable.Results: The analysis demonstrated no significant difference for CR rate (OR= 0.98,95%CI 0.77-1.24，P=0.85)between RCHOP-14 and RCHOP-21. Compared with RCHOP-21, the merged hazard ratio (HR) for PFS and OS was, respectively, 0.94 (95% CI: 0.84-1.06, P=0.32) and 0.91(95% CI: 0.83-1.01, P= 0.08) after treatment with RCHOP-14.A subgroup analysis based on the international prognostic index(IPI) score showed that both chemotherapy regimens were applicable in B-cell NHL patients with different prognosis. The frequency of toxic side-effects was similar between schemes.Conclusions: Therefore, the data presented suggest that the efficacy and safety of both regimens are comparable and that R-CHOP14 remains a viable plan in B-cell NHL patients who prefer a shorter therapy course.

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Outcomes after R-CHOP in patients with newly diagnosed advanced follicular lymphoma: a 10-year follow-up analysis of the JCOG0203 trial

Cited by 20 publications

References 31 publications

Prognostic significance of histologic grade and Ki‐67 proliferation index in follicular lymphoma

Prognostic significance of histologic grade and Ki‐67 proliferation index in follicular lymphoma

The impact of prior malignancies on the development of second malignancies and survival in follicular lymphoma: A population‐based study

Therapy with of RCHOP-14 Versus RCHOP-21 for People With Aggressive or Advanced Stage Indolent B-Cell Non-Hodgkins Lymphoma: A Systematic Review and Meta-Analysis

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