Contributions
Abstract: PB2027
Type: Publication Only
Background
Follicular lymphoma (FL) is the most frequent type of indolent lymphoma in western countries, but it is less frequent in Asia. Several trials have demonstrated the progression-free benefit of rituximab maintenance (R-maintenance) in FL in western countries. However, the overall-survival benefits of R-maintenance in Asian FL patients remain uncertain.
Aims
We utilized the Taiwan Cancer Registry Database (TCRD), the National Death Registry Database (NDRD), and the National Health Insurance Research Database (NHIRD) to investigate the clinical importance of R-maintenance for newly diagnosed FL patients in Taiwan.
Methods
From TCRD, we identified 836 patients with newly diagnosed FL during 2009 to 2012. We retrieved the clinical information from NHIRD, and the survival status from NDRD. We enrolled patients with stage II-IV diseases and receiving 4-8 cycles of rituximab containing frontline chemotherapies. We excluded those who died or received chemotherapies again within 180 days after the end date of the frontline therapies. Total 396 patients were included. Their demographics, clinical parameters, overall survival (OS), and time to next treatment (TTNT) were subjected for analysis.
Results
Among the 396 patients, 260 underwent R-maintenance, and 136 served as the observation group. Compared with the observation group, the R-maintenance group had similar distribution in age, gender, Ann Arbor stages, Charlson Comorbidity scores and the sites of the practice setting. However, those with R-maintenance underwent less intensive frontline chemotherapies (less R-CHOP receiving rate; 53.5% in R-maintenance, versus 66.2% in observation; p value 0.0150) and less cycles of rituximab-containing frontline therapies (the rate of receiving 7-8 cycles frontline therapies, 25.8% in R-maintenance, versus 41.9% in observation; p value 0.0010). The patients receiving R-maintenance had a significantly better OS in univariate analysis (hazard ratio (HR), 0.43; 95% confidence interval (CI), 0.20-0.91), and even in multivariate analysis (HR, 0.42; 95% CI, 0.19-0.91). In the multi-variate analysis, age older more than 60 years and stage IV disease also showed negative impacts on OS. On the other hand, the TTNT was similar in the R-maintenance and observation groups (multivariate analysis, HR, 0.96; 95% CI, 0.65-1.42).
Conclusion
Our study is the first real-world study to demonstrate the OS benefit of R-maintenance after the frontline therapies in newly diagnosed FL patients of Asian population.
Session topic: 20. Indolent Non-Hodgkin lymphoma – Clinical
Keyword(s): Follicular lymphoma, Rituximab, Survival
Abstract: PB2027
Type: Publication Only
Background
Follicular lymphoma (FL) is the most frequent type of indolent lymphoma in western countries, but it is less frequent in Asia. Several trials have demonstrated the progression-free benefit of rituximab maintenance (R-maintenance) in FL in western countries. However, the overall-survival benefits of R-maintenance in Asian FL patients remain uncertain.
Aims
We utilized the Taiwan Cancer Registry Database (TCRD), the National Death Registry Database (NDRD), and the National Health Insurance Research Database (NHIRD) to investigate the clinical importance of R-maintenance for newly diagnosed FL patients in Taiwan.
Methods
From TCRD, we identified 836 patients with newly diagnosed FL during 2009 to 2012. We retrieved the clinical information from NHIRD, and the survival status from NDRD. We enrolled patients with stage II-IV diseases and receiving 4-8 cycles of rituximab containing frontline chemotherapies. We excluded those who died or received chemotherapies again within 180 days after the end date of the frontline therapies. Total 396 patients were included. Their demographics, clinical parameters, overall survival (OS), and time to next treatment (TTNT) were subjected for analysis.
Results
Among the 396 patients, 260 underwent R-maintenance, and 136 served as the observation group. Compared with the observation group, the R-maintenance group had similar distribution in age, gender, Ann Arbor stages, Charlson Comorbidity scores and the sites of the practice setting. However, those with R-maintenance underwent less intensive frontline chemotherapies (less R-CHOP receiving rate; 53.5% in R-maintenance, versus 66.2% in observation; p value 0.0150) and less cycles of rituximab-containing frontline therapies (the rate of receiving 7-8 cycles frontline therapies, 25.8% in R-maintenance, versus 41.9% in observation; p value 0.0010). The patients receiving R-maintenance had a significantly better OS in univariate analysis (hazard ratio (HR), 0.43; 95% confidence interval (CI), 0.20-0.91), and even in multivariate analysis (HR, 0.42; 95% CI, 0.19-0.91). In the multi-variate analysis, age older more than 60 years and stage IV disease also showed negative impacts on OS. On the other hand, the TTNT was similar in the R-maintenance and observation groups (multivariate analysis, HR, 0.96; 95% CI, 0.65-1.42).
Conclusion
Our study is the first real-world study to demonstrate the OS benefit of R-maintenance after the frontline therapies in newly diagnosed FL patients of Asian population.
Session topic: 20. Indolent Non-Hodgkin lymphoma – Clinical
Keyword(s): Follicular lymphoma, Rituximab, Survival