Haematology
Contributions
Type: Publication Only
Background
Follicular lymphomas are usually defined as incurable diseases with a natural history characterized by several relapses. This study was launched to evaluate how many patients, after a long observation period, don not relapse or do not experience a new chemotherapy treatment.
Aims
We aim to identify which clinical characteristics or therapeutical approaches are associated with this cohort of favourable patients.
Methods
All patients with histologically confirmed diagnosis of follicular lymphomas grade I-II or IIIa were selected from our data base starting from January 2000 untill December 2004 in such a way to have at least 10 years of observation for alive patients. We divided patients in two cohorts, cohort 1 with patients relapsed or progressed and cohort 2 with patients never relapsed or progressed.
Results
From January 2000 to December 2004, 146 patients were diagnosed and treated in our Institution. Thirteen patients were excluded from the analysis, 8 because of lost to the follow-up and 5 did not obtained at least a partial remission. Finally 133 patients were selected for the study. The median age at diagnosis was 61 years (range 30-87). Stage I-II in 47 patients, III-IV in 86. Bone marrow biopsy was positive in 87 patients, FLIPI 0-1 in 35, FLIPI 2 in 43, FLIPI 3 in 40 and FLIPI 4 in 15 patients. According to treatment 96 patients were treated with antracycline containing regimens, 24 with fludarabine containing regimens and 13 were observed or treated with radiotherapy. Rituximab was used in 92 patients, as sequential treatment in 70 or chemotherapy combined in 22; 41 patients did not use rituximab.
Patients relapsed or progressed represent cohort 1 (85 patients) and those without relapse or progression represent cohort 2 (48 patients). The statistically significant differences between the two cohorts were: elderly patients (p 0.05), symptomatic patients (p 0.05), FLIPI and FLIPI2 high score (p 0.005), lack of complete remission (p 0.0000) all observed in cohort 1. The overall survival with a median period of observation of 115 months (range 2-185) was 71%, considering the two groups the overall survival in cohort 1 was 62% with a median of 142 months and it was 94% in cohort 2 with median not reached. In univariate analysis normal value of beta2 microglobulin (p 0.05) and the use of rituximab (p 0.01) were associated with a better overall survival; in multivariate analysis treatment with rituximab manteined a statistically significance.
Summary
In conclusion this retrospective monocentric study confirms that about one third of follicular lymphoma patients could be considered cured particularly if rituximab was used in the treatment. At the present time all patients with follicular lymphoma are treated with combined immuno-chemotherapy, moreover after induction therapy patients are started on manteinance. We can therefore hope for the future in an improvement of survival results.
Keyword(s): Follicular lymphoma, Relapse
Session topic: Publication Only
Type: Publication Only
Background
Follicular lymphomas are usually defined as incurable diseases with a natural history characterized by several relapses. This study was launched to evaluate how many patients, after a long observation period, don not relapse or do not experience a new chemotherapy treatment.
Aims
We aim to identify which clinical characteristics or therapeutical approaches are associated with this cohort of favourable patients.
Methods
All patients with histologically confirmed diagnosis of follicular lymphomas grade I-II or IIIa were selected from our data base starting from January 2000 untill December 2004 in such a way to have at least 10 years of observation for alive patients. We divided patients in two cohorts, cohort 1 with patients relapsed or progressed and cohort 2 with patients never relapsed or progressed.
Results
From January 2000 to December 2004, 146 patients were diagnosed and treated in our Institution. Thirteen patients were excluded from the analysis, 8 because of lost to the follow-up and 5 did not obtained at least a partial remission. Finally 133 patients were selected for the study. The median age at diagnosis was 61 years (range 30-87). Stage I-II in 47 patients, III-IV in 86. Bone marrow biopsy was positive in 87 patients, FLIPI 0-1 in 35, FLIPI 2 in 43, FLIPI 3 in 40 and FLIPI 4 in 15 patients. According to treatment 96 patients were treated with antracycline containing regimens, 24 with fludarabine containing regimens and 13 were observed or treated with radiotherapy. Rituximab was used in 92 patients, as sequential treatment in 70 or chemotherapy combined in 22; 41 patients did not use rituximab.
Patients relapsed or progressed represent cohort 1 (85 patients) and those without relapse or progression represent cohort 2 (48 patients). The statistically significant differences between the two cohorts were: elderly patients (p 0.05), symptomatic patients (p 0.05), FLIPI and FLIPI2 high score (p 0.005), lack of complete remission (p 0.0000) all observed in cohort 1. The overall survival with a median period of observation of 115 months (range 2-185) was 71%, considering the two groups the overall survival in cohort 1 was 62% with a median of 142 months and it was 94% in cohort 2 with median not reached. In univariate analysis normal value of beta2 microglobulin (p 0.05) and the use of rituximab (p 0.01) were associated with a better overall survival; in multivariate analysis treatment with rituximab manteined a statistically significance.
Summary
In conclusion this retrospective monocentric study confirms that about one third of follicular lymphoma patients could be considered cured particularly if rituximab was used in the treatment. At the present time all patients with follicular lymphoma are treated with combined immuno-chemotherapy, moreover after induction therapy patients are started on manteinance. We can therefore hope for the future in an improvement of survival results.
Keyword(s): Follicular lymphoma, Relapse
Session topic: Publication Only