DE NOVO TRANSFORMED FOLICULAR LYMPHOMA. OUTCOMES AND ROLE OF AUTOLOGOUS STEM CELL TRANSPLANTATION
(Abstract release date: 05/19/16)
EHA Library. Alcoceba M. 06/09/16; 132517; E968
Dr. Miguel Alcoceba
Contributions
Contributions
Abstract
Abstract: E968
Type: Eposter Presentation
Background
The role of histologic transformation (HT) on survival of follicular lymphoma (FL) in the rituximab era has been recently analyzed in several studies. However, there is no information about the outcome of patients with simultaneous presence of FL and diffuse large B cell lymphoma (DLBCL) in the same initial diagnostic biopsy (de novo transformed FL; dn-tFL).
Aims
We examined clinical characteristics, survival following transformation (SFT) and impact of intensive regimens (including ASCT) in a group of patients diagnosed of dn-tFL, and compared them with a group of FL patients who developed HT (tFL).
Methods
We recruited 1809 patient candidates from a retrospective series in 18 centres from the Spanish Group of Lymphoma and Autologous Stem Cell Transplantation (GELTAMO). Of them, 75 patients were diagnosed of dn-tFL, and the other 1734 of FL grade 1-3a, from which 106 developed HT. Treatment at HT consisted in rituximab containing regimens.
Results
Clinical variables were not significantly different between tFL and dn-tFL. 5-year SFT was significantly higher in dn-tFL as compared to tFL patients (75% vs. 25%, p<0.0001; Figure 1A). Variables influencing 5-year SFT in dn-tFL were complete response (CR) to front line therapy (90% vs. 41%, p<0.001; Figure 1B), and low-risk FLIPI score (100% vs. 58%, p=0.018). In the multivariate analysis, only CR to front line therapy (HR 6.5, 95% CI: 2.0-20.7) had an independent influence on 5-year SFT. In the conventional tFL comparison cohort, achievement of CR (47% vs. 5%, p<0.001; Figure 1B), but not low-risk FLIPI (40% vs. 27%, p=0.2) influenced 5-year SFT.A total of 19 dn-tFL patients did not achieve CR to first-line therapy, and received salvage therapy, which was followed by ASCT as consolidation therapy only in 4 cases. 5-year SFT in the ASCT group was higher (67% vs. 42%, p=0.07). However, these groups were not comparable since patients receiving ASCT were significantly younger than those not receiving ASCT (median 54 years vs. 71 years, p=0.031).
Conclusion
De novo tFL patients have better SFT than patients that develop HT after FL diagnosis. Although differences are evident in terms of general SFT, both groups are characterized by a decisive influence of therapy response in SFT. Interestingly, although FLIPI score is not the standard index to evaluate aggressive lymphoma, it accurately stratified composite FL+DLBCL and not the conventional tFL. In our series, ASCT shows a potential benefit as a rescue therapy in those dn-tFL patients not responding to first-line treatment.
Session topic: E-poster
Keyword(s): Follicular lymphoma, Transformation
Type: Eposter Presentation
Background
The role of histologic transformation (HT) on survival of follicular lymphoma (FL) in the rituximab era has been recently analyzed in several studies. However, there is no information about the outcome of patients with simultaneous presence of FL and diffuse large B cell lymphoma (DLBCL) in the same initial diagnostic biopsy (de novo transformed FL; dn-tFL).
Aims
We examined clinical characteristics, survival following transformation (SFT) and impact of intensive regimens (including ASCT) in a group of patients diagnosed of dn-tFL, and compared them with a group of FL patients who developed HT (tFL).
Methods
We recruited 1809 patient candidates from a retrospective series in 18 centres from the Spanish Group of Lymphoma and Autologous Stem Cell Transplantation (GELTAMO). Of them, 75 patients were diagnosed of dn-tFL, and the other 1734 of FL grade 1-3a, from which 106 developed HT. Treatment at HT consisted in rituximab containing regimens.
Results
Clinical variables were not significantly different between tFL and dn-tFL. 5-year SFT was significantly higher in dn-tFL as compared to tFL patients (75% vs. 25%, p<0.0001; Figure 1A). Variables influencing 5-year SFT in dn-tFL were complete response (CR) to front line therapy (90% vs. 41%, p<0.001; Figure 1B), and low-risk FLIPI score (100% vs. 58%, p=0.018). In the multivariate analysis, only CR to front line therapy (HR 6.5, 95% CI: 2.0-20.7) had an independent influence on 5-year SFT. In the conventional tFL comparison cohort, achievement of CR (47% vs. 5%, p<0.001; Figure 1B), but not low-risk FLIPI (40% vs. 27%, p=0.2) influenced 5-year SFT.A total of 19 dn-tFL patients did not achieve CR to first-line therapy, and received salvage therapy, which was followed by ASCT as consolidation therapy only in 4 cases. 5-year SFT in the ASCT group was higher (67% vs. 42%, p=0.07). However, these groups were not comparable since patients receiving ASCT were significantly younger than those not receiving ASCT (median 54 years vs. 71 years, p=0.031).
Conclusion
De novo tFL patients have better SFT than patients that develop HT after FL diagnosis. Although differences are evident in terms of general SFT, both groups are characterized by a decisive influence of therapy response in SFT. Interestingly, although FLIPI score is not the standard index to evaluate aggressive lymphoma, it accurately stratified composite FL+DLBCL and not the conventional tFL. In our series, ASCT shows a potential benefit as a rescue therapy in those dn-tFL patients not responding to first-line treatment.
Session topic: E-poster
Keyword(s): Follicular lymphoma, Transformation
Abstract: E968
Type: Eposter Presentation
Background
The role of histologic transformation (HT) on survival of follicular lymphoma (FL) in the rituximab era has been recently analyzed in several studies. However, there is no information about the outcome of patients with simultaneous presence of FL and diffuse large B cell lymphoma (DLBCL) in the same initial diagnostic biopsy (de novo transformed FL; dn-tFL).
Aims
We examined clinical characteristics, survival following transformation (SFT) and impact of intensive regimens (including ASCT) in a group of patients diagnosed of dn-tFL, and compared them with a group of FL patients who developed HT (tFL).
Methods
We recruited 1809 patient candidates from a retrospective series in 18 centres from the Spanish Group of Lymphoma and Autologous Stem Cell Transplantation (GELTAMO). Of them, 75 patients were diagnosed of dn-tFL, and the other 1734 of FL grade 1-3a, from which 106 developed HT. Treatment at HT consisted in rituximab containing regimens.
Results
Clinical variables were not significantly different between tFL and dn-tFL. 5-year SFT was significantly higher in dn-tFL as compared to tFL patients (75% vs. 25%, p<0.0001; Figure 1A). Variables influencing 5-year SFT in dn-tFL were complete response (CR) to front line therapy (90% vs. 41%, p<0.001; Figure 1B), and low-risk FLIPI score (100% vs. 58%, p=0.018). In the multivariate analysis, only CR to front line therapy (HR 6.5, 95% CI: 2.0-20.7) had an independent influence on 5-year SFT. In the conventional tFL comparison cohort, achievement of CR (47% vs. 5%, p<0.001; Figure 1B), but not low-risk FLIPI (40% vs. 27%, p=0.2) influenced 5-year SFT.A total of 19 dn-tFL patients did not achieve CR to first-line therapy, and received salvage therapy, which was followed by ASCT as consolidation therapy only in 4 cases. 5-year SFT in the ASCT group was higher (67% vs. 42%, p=0.07). However, these groups were not comparable since patients receiving ASCT were significantly younger than those not receiving ASCT (median 54 years vs. 71 years, p=0.031).
Conclusion
De novo tFL patients have better SFT than patients that develop HT after FL diagnosis. Although differences are evident in terms of general SFT, both groups are characterized by a decisive influence of therapy response in SFT. Interestingly, although FLIPI score is not the standard index to evaluate aggressive lymphoma, it accurately stratified composite FL+DLBCL and not the conventional tFL. In our series, ASCT shows a potential benefit as a rescue therapy in those dn-tFL patients not responding to first-line treatment.
Session topic: E-poster
Keyword(s): Follicular lymphoma, Transformation
Type: Eposter Presentation
Background
The role of histologic transformation (HT) on survival of follicular lymphoma (FL) in the rituximab era has been recently analyzed in several studies. However, there is no information about the outcome of patients with simultaneous presence of FL and diffuse large B cell lymphoma (DLBCL) in the same initial diagnostic biopsy (de novo transformed FL; dn-tFL).
Aims
We examined clinical characteristics, survival following transformation (SFT) and impact of intensive regimens (including ASCT) in a group of patients diagnosed of dn-tFL, and compared them with a group of FL patients who developed HT (tFL).
Methods
We recruited 1809 patient candidates from a retrospective series in 18 centres from the Spanish Group of Lymphoma and Autologous Stem Cell Transplantation (GELTAMO). Of them, 75 patients were diagnosed of dn-tFL, and the other 1734 of FL grade 1-3a, from which 106 developed HT. Treatment at HT consisted in rituximab containing regimens.
Results
Clinical variables were not significantly different between tFL and dn-tFL. 5-year SFT was significantly higher in dn-tFL as compared to tFL patients (75% vs. 25%, p<0.0001; Figure 1A). Variables influencing 5-year SFT in dn-tFL were complete response (CR) to front line therapy (90% vs. 41%, p<0.001; Figure 1B), and low-risk FLIPI score (100% vs. 58%, p=0.018). In the multivariate analysis, only CR to front line therapy (HR 6.5, 95% CI: 2.0-20.7) had an independent influence on 5-year SFT. In the conventional tFL comparison cohort, achievement of CR (47% vs. 5%, p<0.001; Figure 1B), but not low-risk FLIPI (40% vs. 27%, p=0.2) influenced 5-year SFT.A total of 19 dn-tFL patients did not achieve CR to first-line therapy, and received salvage therapy, which was followed by ASCT as consolidation therapy only in 4 cases. 5-year SFT in the ASCT group was higher (67% vs. 42%, p=0.07). However, these groups were not comparable since patients receiving ASCT were significantly younger than those not receiving ASCT (median 54 years vs. 71 years, p=0.031).
Conclusion
De novo tFL patients have better SFT than patients that develop HT after FL diagnosis. Although differences are evident in terms of general SFT, both groups are characterized by a decisive influence of therapy response in SFT. Interestingly, although FLIPI score is not the standard index to evaluate aggressive lymphoma, it accurately stratified composite FL+DLBCL and not the conventional tFL. In our series, ASCT shows a potential benefit as a rescue therapy in those dn-tFL patients not responding to first-line treatment.
Session topic: E-poster
Keyword(s): Follicular lymphoma, Transformation
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