IS LIMITED STAGE FOLLICULAR LYMPHOMA (FL) A TRULY CURABLE DISEASE? A RETROSPECTIVE ANALYSIS ON 79 PATIENTS
(Abstract release date: 05/19/16)
EHA Library. K Angelopoulou M. 06/09/16; 132711; E1162
Dr. Maria K Angelopoulou
Contributions
Contributions
Abstract
Abstract: E1162
Type: Eposter Presentation
Background
Limited stage I/II FL is considered potentially curable in contrast to advanced stage (III/IV) disease. The most widely accepted treatment strategy is local radiotherapy (RT), occasionally followed by rituximab (R) monotherapy. However, studies specifically focusing on localized FL are limited.
Aims
To study the clinical and laboratory characteristics of limited stage FL and explore long-term outcomes.
Methods
We retrospectively studied all patients with FL diagnosed and treated in a single University Hematology Unit between 2001 and 2015 and stage I/II cases were recorded.
Results
Among 200 consecutive patients (median follow-up 76 months), 79 patients with limited stages were identified: 55 stage I and 24 stage II. Treatment differed according to histologic grade (p=0.002): RT±R was used in 53% of grade 1/2 histologies, whereas R-CHOP was administered in 54% of grade 3 cases. 5-and 10-year progression free survival (PFS) was 61% and 45%, respectively, while the corresponding values for overall survival (OS) were 94% and 90%. A plateau in the PFS curve was observed beyond 8 years. Disease bulk was identified as a borderline significant factor for PFS (p=0.09): Patients with bulky disease had a 5- and 10-year PFS of 43% and 29% vs 65% and 49% for those with non-bulky disease. The comparison of limited vs advanced disease stage revealed no significant differences regarding histologic grade, gender, age and bulk. FLIPI differed significantly, as expected (p<0.0001): 91% of limited stage patients had a low FLIPI score, whereas 78% of advanced stage ones had intermediate and high FLIPI scores. LDH was elevated in 5.3% of localized and 17.5% of advanced disease (p=0.01). There was a trend for higher Ki-67 in limited stages (p=0.07). Treatment also differed significantly, as expected (p<0.0001): 44% of limited stage patients were treated with RT±R vs 0.8% of advanced stage ones, whereas systemic chemotherapy was used in 53% and 92% of localized and advanced stage FL patients, respectively. Despite treatment heterogeneity, PFS and OS did not differ significantly between limited and advanced stage disease. However, there was a trend for superior OS in localized disease patients beyond 5 years (figure).
Conclusion
Although limited stage FL is considered as a potentially curable disease, the present retrospective analysis revealed a relapsing pattern, similar to the one observed in advanced disease for the initial years of follow-up. However, beyond 8 years, survival curves are suggestive of a plateau, a finding that should be further confirmed. OS is excellent with 90% of the patients being alive at 10 years. The optimal treatment for this group of patients needs further investigation.
Session topic: E-poster
Type: Eposter Presentation
Background
Limited stage I/II FL is considered potentially curable in contrast to advanced stage (III/IV) disease. The most widely accepted treatment strategy is local radiotherapy (RT), occasionally followed by rituximab (R) monotherapy. However, studies specifically focusing on localized FL are limited.
Aims
To study the clinical and laboratory characteristics of limited stage FL and explore long-term outcomes.
Methods
We retrospectively studied all patients with FL diagnosed and treated in a single University Hematology Unit between 2001 and 2015 and stage I/II cases were recorded.
Results
Among 200 consecutive patients (median follow-up 76 months), 79 patients with limited stages were identified: 55 stage I and 24 stage II. Treatment differed according to histologic grade (p=0.002): RT±R was used in 53% of grade 1/2 histologies, whereas R-CHOP was administered in 54% of grade 3 cases. 5-and 10-year progression free survival (PFS) was 61% and 45%, respectively, while the corresponding values for overall survival (OS) were 94% and 90%. A plateau in the PFS curve was observed beyond 8 years. Disease bulk was identified as a borderline significant factor for PFS (p=0.09): Patients with bulky disease had a 5- and 10-year PFS of 43% and 29% vs 65% and 49% for those with non-bulky disease. The comparison of limited vs advanced disease stage revealed no significant differences regarding histologic grade, gender, age and bulk. FLIPI differed significantly, as expected (p<0.0001): 91% of limited stage patients had a low FLIPI score, whereas 78% of advanced stage ones had intermediate and high FLIPI scores. LDH was elevated in 5.3% of localized and 17.5% of advanced disease (p=0.01). There was a trend for higher Ki-67 in limited stages (p=0.07). Treatment also differed significantly, as expected (p<0.0001): 44% of limited stage patients were treated with RT±R vs 0.8% of advanced stage ones, whereas systemic chemotherapy was used in 53% and 92% of localized and advanced stage FL patients, respectively. Despite treatment heterogeneity, PFS and OS did not differ significantly between limited and advanced stage disease. However, there was a trend for superior OS in localized disease patients beyond 5 years (figure).
Conclusion
Although limited stage FL is considered as a potentially curable disease, the present retrospective analysis revealed a relapsing pattern, similar to the one observed in advanced disease for the initial years of follow-up. However, beyond 8 years, survival curves are suggestive of a plateau, a finding that should be further confirmed. OS is excellent with 90% of the patients being alive at 10 years. The optimal treatment for this group of patients needs further investigation.
Session topic: E-poster
Abstract: E1162
Type: Eposter Presentation
Background
Limited stage I/II FL is considered potentially curable in contrast to advanced stage (III/IV) disease. The most widely accepted treatment strategy is local radiotherapy (RT), occasionally followed by rituximab (R) monotherapy. However, studies specifically focusing on localized FL are limited.
Aims
To study the clinical and laboratory characteristics of limited stage FL and explore long-term outcomes.
Methods
We retrospectively studied all patients with FL diagnosed and treated in a single University Hematology Unit between 2001 and 2015 and stage I/II cases were recorded.
Results
Among 200 consecutive patients (median follow-up 76 months), 79 patients with limited stages were identified: 55 stage I and 24 stage II. Treatment differed according to histologic grade (p=0.002): RT±R was used in 53% of grade 1/2 histologies, whereas R-CHOP was administered in 54% of grade 3 cases. 5-and 10-year progression free survival (PFS) was 61% and 45%, respectively, while the corresponding values for overall survival (OS) were 94% and 90%. A plateau in the PFS curve was observed beyond 8 years. Disease bulk was identified as a borderline significant factor for PFS (p=0.09): Patients with bulky disease had a 5- and 10-year PFS of 43% and 29% vs 65% and 49% for those with non-bulky disease. The comparison of limited vs advanced disease stage revealed no significant differences regarding histologic grade, gender, age and bulk. FLIPI differed significantly, as expected (p<0.0001): 91% of limited stage patients had a low FLIPI score, whereas 78% of advanced stage ones had intermediate and high FLIPI scores. LDH was elevated in 5.3% of localized and 17.5% of advanced disease (p=0.01). There was a trend for higher Ki-67 in limited stages (p=0.07). Treatment also differed significantly, as expected (p<0.0001): 44% of limited stage patients were treated with RT±R vs 0.8% of advanced stage ones, whereas systemic chemotherapy was used in 53% and 92% of localized and advanced stage FL patients, respectively. Despite treatment heterogeneity, PFS and OS did not differ significantly between limited and advanced stage disease. However, there was a trend for superior OS in localized disease patients beyond 5 years (figure).
Conclusion
Although limited stage FL is considered as a potentially curable disease, the present retrospective analysis revealed a relapsing pattern, similar to the one observed in advanced disease for the initial years of follow-up. However, beyond 8 years, survival curves are suggestive of a plateau, a finding that should be further confirmed. OS is excellent with 90% of the patients being alive at 10 years. The optimal treatment for this group of patients needs further investigation.
Session topic: E-poster
Type: Eposter Presentation
Background
Limited stage I/II FL is considered potentially curable in contrast to advanced stage (III/IV) disease. The most widely accepted treatment strategy is local radiotherapy (RT), occasionally followed by rituximab (R) monotherapy. However, studies specifically focusing on localized FL are limited.
Aims
To study the clinical and laboratory characteristics of limited stage FL and explore long-term outcomes.
Methods
We retrospectively studied all patients with FL diagnosed and treated in a single University Hematology Unit between 2001 and 2015 and stage I/II cases were recorded.
Results
Among 200 consecutive patients (median follow-up 76 months), 79 patients with limited stages were identified: 55 stage I and 24 stage II. Treatment differed according to histologic grade (p=0.002): RT±R was used in 53% of grade 1/2 histologies, whereas R-CHOP was administered in 54% of grade 3 cases. 5-and 10-year progression free survival (PFS) was 61% and 45%, respectively, while the corresponding values for overall survival (OS) were 94% and 90%. A plateau in the PFS curve was observed beyond 8 years. Disease bulk was identified as a borderline significant factor for PFS (p=0.09): Patients with bulky disease had a 5- and 10-year PFS of 43% and 29% vs 65% and 49% for those with non-bulky disease. The comparison of limited vs advanced disease stage revealed no significant differences regarding histologic grade, gender, age and bulk. FLIPI differed significantly, as expected (p<0.0001): 91% of limited stage patients had a low FLIPI score, whereas 78% of advanced stage ones had intermediate and high FLIPI scores. LDH was elevated in 5.3% of localized and 17.5% of advanced disease (p=0.01). There was a trend for higher Ki-67 in limited stages (p=0.07). Treatment also differed significantly, as expected (p<0.0001): 44% of limited stage patients were treated with RT±R vs 0.8% of advanced stage ones, whereas systemic chemotherapy was used in 53% and 92% of localized and advanced stage FL patients, respectively. Despite treatment heterogeneity, PFS and OS did not differ significantly between limited and advanced stage disease. However, there was a trend for superior OS in localized disease patients beyond 5 years (figure).
Conclusion
Although limited stage FL is considered as a potentially curable disease, the present retrospective analysis revealed a relapsing pattern, similar to the one observed in advanced disease for the initial years of follow-up. However, beyond 8 years, survival curves are suggestive of a plateau, a finding that should be further confirmed. OS is excellent with 90% of the patients being alive at 10 years. The optimal treatment for this group of patients needs further investigation.
Session topic: E-poster
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