Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma. Academic Article uri icon

Overview

abstract

  • Between 1998 and 2009, a total of 295 patients (median age 58, 53% females) with newly diagnosed early-stage follicular lymphoma (FL) were managed at Memorial Sloan Kettering Cancer Center. Approximately half of patients (137, 46%) underwent initial observation and half (158, 54%) immediate treatment: radiation alone (n = 108), systemic treatment alone (n = 29), or combined modality treatment (n = 21). Median follow-up was 8.4 years (range 0.3-17.2), and 10-year overall survival (OS) was 87.2%. OS was similar between initially-observed and immediately-treated patients (hazard ratio [HR]: 1.25, 95% CI: 0.67-2.36, p = 0.49). For patients receiving radiation alone, 5-year OS was 98.0%. Patients selected for systemic therapy alone had high-risk baseline features and had shorter OS than patients treated with radiation alone (HR 3.38, 95% CI 1.29-8.86, p = 0.01). Combined modality treatment did not yield superior survival compared with radiation alone (P > 0.05) but was associated with better progression-free survival (HR 0.36, 95% CI 0.14-0.90, p = 0.03). The rate of transformation increased steadily over time and was 4.2% at 5 years and 10.8% at 10 years. This modern-era analysis rationalized the role of initial observation in patients with early-stage FL although patients receiving radiation therapy also demonstrate excellent outcome.

authors

  • Sha, Fushen
  • Okwali, Michelle
  • Alperovich, Anna
  • Caron, Philip C
  • Falchi, Lorenzo
  • Hamilton, Audrey
  • Hamlin, Paul A
  • Horwitz, Steven M
  • Joffe, Erel
  • Khan, Niloufer
  • Kumar, Anita
  • Matasar, Matthew J
  • Moskowitz, Alison J
  • Noy, Ariela
  • Owens, Colette
  • Palomba, Lia M
  • Rodriguez-Rivera, Ildefonso
  • Straus, David
  • von Keudell, Gottfried
  • Zelenetz, Andrew D
  • Yahalom, Joachim
  • Dogan, Ahmet
  • Schöder, Heiko
  • Seshan, Venkatraman E
  • Salles, Gilles
  • Younes, Anas
  • Batlevi, Connie L

publication date

  • February 10, 2022

Research

keywords

  • Lymphoma, Follicular

Identity

PubMed Central ID

  • PMC8831497

Scopus Document Identifier

  • 85124446447

Digital Object Identifier (DOI)

  • 10.1182/blood-2019-123106

PubMed ID

  • 35145059

Additional Document Info

volume

  • 12

issue

  • 2