Risk of, and survival following, histological transformation in follicular lymphoma in the rituximab era. A retrospective multicentre study by the Spanish GELTAMO group
Por:
Alonso-Alvarez, S, Magnano, L, Alco-Ceba, M, Andrade-Campos, M, Espinosa-Lara, N, Rodriguez, G, Mercadal, S, Carro, I, Sancho, JM, Moreno, M, Salar, A, Garcia-Pallarols, F, Arranz, R, Cannata, J, Terol, MJ, Teruel, AI, Rodriguez, A, Jimenez-Ubieto, A, de Villambrosia, SG, Bello, JL, Lopez, L, Monsalvo, S, Novelli, S, de Cabo, E, Infante, MS, Pardal, E, Garcia-Alvarez, M, Delgado, J, Gonzalez, M, Martin, A, Lopez-Guillermo, A, Caballero, MD
Publicada:
1 sep 2017
Resumen:
The diagnostic criteria for follicular lymphoma (FL) transformation vary among the largest series, which commonly exclude histologically-documented transformation (HT) mandatorily. The aims of this retrospective observational multicentre study by the Spanish Grupo Espanol de Linfoma y Transplante Autologo de Medula Osea, which recruited 1734 patients (800 males/934 females; median age 59 years), diagnosed with FL grades 1-3A, were, (i) the cumulative incidence of HT (CI-HT); (ii) risk factors associated with HT; and (iii) the role of treatment and response on survival following transformation (SFT). With a median follow-up of 6.2 years, 106 patients developed HT. Ten-year CI-HT was 8%. Considering these 106 patients who developed HT, median time to transformation was 2.5 years. High-risk FL International Prognostic Index [Hazard ratio (HR) 2.6, 95% confidence interval (CI): 1.5-4.5] and non-response to first-line therapy (HR 2.9, 95% CI: 1.3-6.8) were associated with HT. Seventy out of the 106 patients died (5-year SFT, 26%). Response to HT first-line therapy (HR 5.3, 95% CI: 2.4-12.0), autologous stem cell transplantation (HR 3.9, 95% CI: 1.5-10.1), and revised International Prognostic Index (HR 2.2, 95% CI: 1.1-4.2) were significantly associated with SFT. Response to treatment and HT were the variables most significantly associated with survival in the rituximab era. Better therapies are needed to improve response. Inclusion of HT in clinical trials with new agents is mandatory.
Filiaciones:
Alonso-Alvarez, S:
Hosp Univ Salamanca IBSAL, Salamanca, Spain
GELTAMO, La Coruna, Spain
Magnano, L:
Hosp Clin Barcelona, Salamanca, Spain
GELTAMO, La Coruna, Spain
Alco-Ceba, M:
Hosp Univ Salamanca IBSAL, Salamanca, Spain
GELTAMO, La Coruna, Spain
CIBERONC, Valencia, Spain
Andrade-Campos, M:
Hosp Univ Miguel Servet Zaragoza CIBERER, IIS Aragon ISCIII, Zaragoza, Spain
GELTAMO, La Coruna, Spain
Espinosa-Lara, N:
Hosp Univ Miguel Servet Zaragoza CIBERER, IIS Aragon ISCIII, Zaragoza, Spain
GELTAMO, La Coruna, Spain
Rodriguez, G:
Hosp Virgen del Rocio Sevilla, Seville, Spain
GELTAMO, La Coruna, Spain
Mercadal, S:
Inst Catalan Oncol ICO Duran & Reynals, Barcelona, Spain
GELTAMO, La Coruna, Spain
Carro, I:
Inst Catalan Oncol ICO Duran & Reynals, Barcelona, Spain
GELTAMO, La Coruna, Spain
Sancho, JM:
Inst Catalan Oncol ICO IJC German Trias & Pujol, Barcelona, Spain
GELTAMO, La Coruna, Spain
Moreno, M:
Inst Catalan Oncol ICO IJC German Trias & Pujol, Barcelona, Spain
GELTAMO, La Coruna, Spain
Salar, A:
Hosp del Mar, Barcelona, Spain
GELTAMO, La Coruna, Spain
Garcia-Pallarols, F:
Hosp del Mar, Barcelona, Spain
GELTAMO, La Coruna, Spain
Arranz, R:
Hosp La Princesa, Madrid, Spain
GELTAMO, La Coruna, Spain
Cannata, J:
Hosp La Princesa, Madrid, Spain
GELTAMO, La Coruna, Spain
Terol, MJ:
Hosp Clin, Valencia, Spain
GELTAMO, La Coruna, Spain
Teruel, AI:
Hosp Clin, Valencia, Spain
GELTAMO, La Coruna, Spain
Rodriguez, A:
Hosp 12 Octubre, Madrid, Spain
GELTAMO, La Coruna, Spain
Jimenez-Ubieto, A:
Hosp 12 Octubre, Madrid, Spain
GELTAMO, La Coruna, Spain
de Villambrosia, SG:
Hosp Marques de Valdecilla, Santander, Spain
GELTAMO, La Coruna, Spain
Bello, JL:
Hosp Univ Santiago de Compostela, Santiago De Compostela, Spain
GELTAMO, La Coruna, Spain
Lopez, L:
Hosp MD Anderson, Madrid, Spain
GELTAMO, La Coruna, Spain
Monsalvo, S:
Hosp Fdn Jimenez Diaz, Madrid, Spain
GELTAMO, La Coruna, Spain
Novelli, S:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
GELTAMO, La Coruna, Spain
de Cabo, E:
Hosp Bierzo, Ponferrada, Spain
GELTAMO, La Coruna, Spain
Infante, MS:
Hosp Infanta Leonor, Madrid, Spain
GELTAMO, La Coruna, Spain
Pardal, E:
Hosp Virgen del Puerto, Plasencia, Spain
GELTAMO, La Coruna, Spain
Garcia-Alvarez, M:
Hosp Univ Salamanca IBSAL, Salamanca, Spain
GELTAMO, La Coruna, Spain
Delgado, J:
Hosp Clin Barcelona, Salamanca, Spain
CIBERONC, Valencia, Spain
Gonzalez, M:
Hosp Univ Salamanca IBSAL, Salamanca, Spain
GELTAMO, La Coruna, Spain
CIBERONC, Valencia, Spain
Martin, A:
Hosp Univ Salamanca IBSAL, Salamanca, Spain
GELTAMO, La Coruna, Spain
CIBERONC, Valencia, Spain
Lopez-Guillermo, A:
Hosp Clin Barcelona, Salamanca, Spain
GELTAMO, La Coruna, Spain
CIBERONC, Valencia, Spain
Caballero, MD:
Hosp Univ Salamanca IBSAL, Salamanca, Spain
GELTAMO, La Coruna, Spain
CIBERONC, Valencia, Spain
Bronze
|