Transformed follicular non-Hodgkin lymphoma

1,273

1,032

Section: Patient Selectionmentioning

confidence: 99%

Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study

Crump

Neelapu

Farooq

et al. 2017

1,273

1,032

“…The gold standard for diagnosing a transformation in FL is with biopsy, 16 and most of the previously published studies required pathological confirmation of transformation. 1,6,7,9,17 The Vancouver population-based analysis identified 170 patients with transformation, including 107 confirmed by biopsy and 63 diagnosed clinically based on the presence of at least one of the following: LDH $2 times the ULN, rapid localized nodal growth, new involvement of unusual extranodal sites, new B symptoms, or hypercalcemia.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of transformed follicular lymphoma in the modern era: a report from the National LymphoCare Study (NLCS)

Wagner‐Johnston

Link

Byrtek³

et al. 2015

Self Cite

182

170

Key Points• The median posttransformation survival of 5 years suggests improved outcomes for transformed FL in the modern era.• Five-year progression-free and overall survival (66% and 88%) are favorable for patients with evidence of transformation at diagnosis.We assessed the incidence, prognostic features, and outcomes associated with transformation of follicular lymphoma (FL) among 2652 evaluable patients prospectively enrolled in the National LymphoCare Study. At a median follow-up of 6. , 83-86). The median overall survival posttransformation was 5 years. Forty-seven patients with evidence of transformation at the time of diagnosis shared similar prognostic factors and survival rates to those without transformation. Improved outcomes for transformation in the modern era are suggested by this observational study. This trial is registered at www.clinicaltrials.gov as #NCT00097565. (Blood. 2015;126(7):851-857)

“…1,2,4,5,[19][20][21][22]25 The role of upfront autologous stem cell transplant following first remission in transformed lymphomas has not been well established and there is no data assessing its role in discordant cases. 51,52 An increased risk of central nervous system (CNS) involvement and CNS relapse in newly diagnosed patients with DLBCL who have concordant BMI has been well described, [53][54][55] and therefore cerebrospinal fluid sampling for lymphomatous involvement and prophylactic CNS-directed therapy are common practice. 56,57 In contrast, discordant indolent BMI in patients with nodal DLBCL has not been associated with an increased risk of CNS involvement/relapse and should not mandate cerebrospinal fluid sampling in the absence of other high-risk characteristics.…”

Section: Therapeutic Approach To Discordant Lymphomasmentioning

confidence: 99%

Discordant bone marrow involvement in non-Hodgkin lymphoma

Brudno

Tadmor

Pittaluga

et al. 2016

A discordant lymphoma occurs where 2 distinct histologic subtypes coexist in at least 2 separate anatomic sites. Histologic discordance is most commonly observed between the bone marrow (BM) and lymph nodes (LNs), where typically aggressive lymphoma is found in a LN biopsy with indolent lymphoma in a BM biopsy. Although the diagnosis of discordance relied heavily on histopathology alone in the past, the availability of flow cytometry and molecular studies have aided the identification of this entity. The true prevalence and clinical ramifications of discordance remain controversial as available data are principally retrospective, and there is therefore little consensus to guide optimal management strategies. In this review, we examine the available literature on discordant lymphoma and its outcome, and discuss current therapeutic approaches. Future studies in discordant lymphoma should ideally focus on a large series of patients with adequate tissue samples and incorporate molecular analyses.