Follicular lymphoma in the modern era: survival, treatment outcomes, and identification of high-risk subgroups.
Adult
Aged
Aged, 80 and over
Combined Modality Therapy
Disease Management
Female
Follow-Up Studies
Humans
Lymphoma, Follicular
/ diagnosis
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Prognosis
Public Health Surveillance
Retrospective Studies
Risk Assessment
Risk Factors
Survival Analysis
Survival Rate
Treatment Outcome
Young Adult
Journal
Blood cancer journal
ISSN: 2044-5385
Titre abrégé: Blood Cancer J
Pays: United States
ID NLM: 101568469
Informations de publication
Date de publication:
17 07 2020
17 07 2020
Historique:
received:
24
04
2020
accepted:
26
06
2020
revised:
18
06
2020
entrez:
18
7
2020
pubmed:
18
7
2020
medline:
23
3
2021
Statut:
epublish
Résumé
Patients with follicular lymphoma (FL) frequently require multiple treatments during their disease course; however, survival based on lines of treatment remains poorly described in the post-rituximab era. Also, the Follicular Lymphoma International Prognostic Index (FLIPI) score was developed to predict survival at diagnosis, yet it remains unknown whether increase in FLIPI score following an initial observation period is associated with less-favorable outcomes. To address these knowledge gaps, we retrospectively studied 1088 patients with FL grade 1-3A managed between 1998 and 2009 at our institution. Median overall survival (OS) and progression-free survival (PFS) after first-line treatment were not reached and 4.73 years, respectively. Following successive lines of treatment, years of median OS and PFS were, respectively: after second-line, 11.7 and 1.5; third-line, 8.8 and 1.1; fourth-line, 5.3 and 0.9; fifth-line, 3.1 and 0.6; sixth-line, 1.9 and 0.5. In initially observed, subsequently treated patients, FLIPI score increase after observation was associated with inferior survival following first-line treatment. The reduced survival we observed after second-line and later therapy supports the development of new treatments for relapsed patients and benchmarks historical targets for clinical endpoints. This study also highlights the utility of changes in FLIPI score at diagnosis and after observation in identifying patients likely to have worse outcomes.
Identifiants
pubmed: 32678074
doi: 10.1038/s41408-020-00340-z
pii: 10.1038/s41408-020-00340-z
pmc: PMC7366724
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
74Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
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