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Impact of prior treatment on outcome of transformed follicular lymphoma and relapsed de novo diffuse large B cell lymphoma: a retrospective multicentre analysis

Item Type:Article
Title:Impact of prior treatment on outcome of transformed follicular lymphoma and relapsed de novo diffuse large B cell lymphoma: a retrospective multicentre analysis
Creators Name:Lerch, K. and Meyer, A.H. and Stroux, A. and Hirt, C. and Keller, U. and Viardot, A. and Marks, R. and Schreiber, S. and Pezzutto, A. and Scholz, C.W.
Abstract:Transformation of follicular lymphoma (FL) into aggressive disease and relapse of de novo diffuse large B cell lymphoma (DLBCL) are considered highly unfavourable events. However, most published data were acquired when rituximab was not routinely used. We retrospectively analysed 50 patients with transformed FL (tFL) in a multicenter study and compared them to 50 individuals with relapsed DLBCL (rDLBCL) who all obtained rituximab for the treatment of their disease. Our goal was to identify factors that predict a more favourable prognosis. After a median follow-up of 5.4 years from diagnosis, there was no significant difference in median overall survival (OS) from the date of transformation (tFL) or date of the first relapse (rDLBCL) (1.9 versus 3.9 years, P = .542). Of note, 5-year OS of patients with tFL was 46 %. Follicular lymphoma patients, treatment naïve prior to transformation, fared significantly better than pretreated patients (median not reached versus 1.4 years, P = .014). Regarding rDLBCL, female gender (13.9 versus 1.8 years, P = .019) and absence of rituximab prior to the first relapse (14.0 versus 1.8 years, P = .035) were favourable prognostic factors in a uni- and multivariate analysis. Only a proportion of patients received high-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT), i.e. 38 and 52 % of patients with tFL and rDLBCL, respectively. Our data indicate that a favourable prognosis is conferred by treatment naivety in tFL and by rituximab naivety in rDLBCL. In contrast, we did not find a prognostic impact of HDT-ASCT in our series.
Keywords:Transformed Follicular Lymphoma, Relapsed Diffuse Large B Cell Llymphoma, Watchful Waiting, Rituximab, High-dose Chemotherapy, Autologous Stem Cell Transplantation
Source:Annals of Hematology
ISSN:0939-5555
Publisher:Springer (Germany)
Volume:94
Number:6
Page Range:981-988
Date:June 2015
Official Publication:https://doi.org/10.1007/s00277-015-2303-5
PubMed:View item in PubMed

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