Risk and Clinical Implications of Transformation of Follicular Lymphoma to Diffuse Large B-Cell Lymphoma

Montoto, Silvia; Davies, Andrew; Matthews, Janet; Calaminici, Maria; Norton, A. J.; Amess, J. A. L.; Vinnicombe, Sarah; Waters, Rachel; Rohatiner, A. Z. S.; Lister, T. Andrew

doi:10.1200/jco.2006.09.3260

Cited by 349 publications

(349 citation statements)

References 31 publications

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“…We observed a transformation rate of 21% among our patients, which is in line with the known histologic transformation rate of follicular lymphoma [13]. Haas et al [9] reported 9% of their patients had transformation to diffuse large B-cell lymphoma.…”

Section: Discussionsupporting

confidence: 72%

Response to low-dose involved-field radiotherapy in patients with non-Hodgkin's lymphoma

Luthy

Silver

et al. 2008

Annals of Oncology

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Background: The purpose of this study was to analyze response to palliative low-dose involved-field radiotherapy (LD-IF-RT) (two 2-Gy fractions), explore factors predicting for response, and determine the time course to subsequent treatment.Patients and methods: Thirty-three patients with advanced or recurrent indolent non-Hodgkin's lymphoma (NHL) received LD-IF-RT to 43 sites. Response was assessed by physical examination and radiographic studies. Median follow-up for individual sites was 14 months. Fisher's exact test was used to evaluate prognostic factors for response and in-field progression.Results: Overall response was 95%. Thirty-six sites (84%) had a complete response (CR), five sites (12%) had a partial response, and two sites (5%) had progressive disease. The CR rate of head and neck sites was significantly higher than that of pelvic and/or inguinofemoral sites (95% versus 64%, P = 0.04). The CR rate was significantly higher for sites £40 mm than for sites >40 mm (90% versus 56%, P = 0.04). Ten sites (23%) had in-field progression diagnosed at a median of 9 months. Sixteen patients (48%) received systemic treatment at a median of 8 months. Fourteen patients (42%) did not require additional treatment.Conclusions: LD-IF-RT for selected NHL subtypes has excellent local CR and in-field control rates and may postpone the need for systemic therapy.

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Section: Discussionsupporting

confidence: 72%

Response to low-dose involved-field radiotherapy in patients with non-Hodgkin's lymphoma

Luthy

Silver

et al. 2008

Annals of Oncology

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“…Transformation from follicular lymphoma into an aggressive lymphoma, usually diffuse large B-cell lymphoma, occurs at a rate of 3% per year. 24 Conconi et al 25 reported histologic transformation in 26% at 14 years in a series of 281 cases treated in Switzerland. In our series, we observed concomitance of diffuse large B-cell lymphoma with follicular lymphoma in 7 (4%) patients at the time of diagnosis.…”

Section: Discussionmentioning

confidence: 97%

Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients

et al. 2013

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Follicular lymphoma is clinically heterogenous, and therefore necessitates the identification of prognostic markers to stratify risk groups and optimize clinical management. It is relatively rare in patients younger than 40 years, and the clinicopathologic characteristics and biological behavior in this age group are poorly understood. In the current study, samples from a cohort of 200 patients between 19 and 40 years were evaluated retrospectively with respect to clinical, histologic, and genetic features. These were then correlated with clinical outcome. The median age at presentation was 35 years with a slight female prepoderance (56%). Most of the cases are presented with nodal disease (90%). Concomitant follicular lymphoma and diffuse large B-cell lymphoma were observed in 7 (4%) patients. Immunohistologic studies showed the expression of CD10 (91%), BCL6 (97%), BCL2 (95%), MUM1/IRF4 (12%), MDM2 (17%), and CD23 (25%). BCL2 rearrangement was present in 74%, and BCL6 in 20%. The estimated overall survival of patients was 13 years (mean). The presence of anemia, elevated lactose dehydrogenase, bone marrow involvement, and high-risk follicular lymphoma international prognostic index correlated with adverse overall survival. Our findings revealed that follicular lymphoma in young adults demonstrate similarities with that of older adults, including the frequency of presentation at various anatomic sites, grade, and adverse prognostic factors.

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“…Majority of our patients were treated with CHOP and 33 of them achieved CR. Transformation to more aggressive lymphoma is known to occur in 10-60 % of the cases [10,11], however it was not documented in any of the 34 cases during the follow up.…”

Section: Discussionmentioning

confidence: 84%

Nodal Follicular Lymphomas: A Clinicopathological Study from a Tertiary Care Centre in South India

Supari

Ananthamurthy

2015

Indian J Hematol Blood Transfus

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The aim of this study was to assess the distribution of nodal follicular lymphomas (FL) among various subtypes of non-Hodgkin lymphoma and to study their clinico-pathological features. Clinical details, histomorphology including grading & patterns and immunoprofile of 44 cases were studied. Majority of the cases were grade 1 (61 %) FL. BCL2 positivity was higher in low grade FLs (97 %). An associated diffuse large B cell lymphoma component was seen in 18 % and was present only in conjunction with grade 3 FL. Majority of our patients (76 %) had a high FLIPI score and belonged to the high risk group. Our study showed that the incidence of FLs is much lower in the Indian population (14.5 %) when compared to western studies and majority were of low grade. Although there was complete initial response to treatment, relapse was common and was much higher in low grade FLs with diffuse areas on histology, Ann Arbor stage III/IV and FLIPI scores of 3-5.

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Risk and Clinical Implications of Transformation of Follicular Lymphoma to Diffuse Large B-Cell Lymphoma

Abstract: Advanced stage and high-risk FLIPI and IPI scores at diagnosis correlate with an increased risk of HT. This event strongly influences the outcome of patients with FL by shortening their survival. There may be a subgroup of patients in whom HT does not occur.

Cited by 349 publications

References 31 publications

Response to low-dose involved-field radiotherapy in patients with non-Hodgkin's lymphoma

Response to low-dose involved-field radiotherapy in patients with non-Hodgkin's lymphoma

Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients

Nodal Follicular Lymphomas: A Clinicopathological Study from a Tertiary Care Centre in South India

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