Outcomes in grade 3B follicular lymphoma: an international study led by the Australasian Lymphoma Alliance.

Autor: Barraclough A; Fiona Stanley Hospital, Department of Haematology, Perth, Australia; University of Melbourne, Melbourne., England JT; University of British Columbia and BC Cancer Centre for Lymphoid Cancer, Vancouver, Canada; Princess Margaret Cancer Centre, Toronto., Villa D; University of British Columbia and BC Cancer Centre for Lymphoid Cancer, Vancouver., Wight J; University of Melbourne, Melbourne, Australia; Townsville University Hospital, Department of Haematology, Townsville., Hapgood G; Princess Alexandra Hospital, Department of Haematology, Brisbane., Conn J; Princess Alexandra Hospital, Department of Haematology, Brisbane., Doo NW; Concord Clinical School, University of Sydney, Sydney., Li EW; Concord Clinical School, University of Sydney, Sydney., Gilbertson M; Monash Health, Department of Haematology, Melbourne, Australia; School of Clinical Sciences, Monash University, Melbourne., Shaw B; Monash Health, Department of Haematology, Melbourne., Bishton MJ; Nottingham City Hospital, Department of Haematology, Nottingham., Saeed M; Nottingham City Hospital, Department of Haematology, Nottingham., Ratnasingam S; University Hospital Geelong, Department of Haematology, Geelong., Abeyakoon C; University Hospital Geelong, Department of Haematology, Geelong., Chong G; University of Melbourne, Melbourne, Australia; Ballarat Regional Integrated Cancer Centre, Ballarat Health Services, Melbourne, Australia; Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne., Wai SH; Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Australia; The Northern Hospital, Department of Haematology, Melbourne., Ku M; University of Melbourne, Melbourne, Australia; St Vincent's Hospital Melbourne, Department of Haematology, Melbourne., Lee HP; Flinders Medical Centre, Department of Haematology, Adelaide., Fleming K; Flinders Medical Centre, Department of Haematology, Adelaide., Tam C; University of Melbourne, Melbourne, Australia; Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Department of Haematology, Melbourne., Douglas G; Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne., Cheah CY; Sir Charles Gairdner Hospital, Department of Haematology, Perth, Australia; University of Western Australia, Medical School, Perth., Ng ZY; Sir Charles Gairdner Hospital, Department of Haematology, Perth., Rolfe T; Greenslopes Private Hospital, Brisbane., Mills AK; Greenslopes Private Hospital, Brisbane., Hamad N; St Vincent's Hospital Sydney, Department of Haematology, Sydney, Australia; School of Clinical Medicine, University of New South Wales, Sydney, Australia; School of Medicine, University of Notre Dame, Sydney., Cashman H; St Vincent's Hospital Sydney, Department of Haematology, Sydney., Gleeson M; Guy's and St. Thomas' NHS Foundation Trust, Department of Haematology, London., Narayana M; Sunshine Coast University Hospital, Department of Haematology, Birtinya., Hawkes EA; Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Australia; Transfusion Research Unit, Monash University, Melbourne. eliza.hawkes@onjcri.org.au.
Jazyk: angličtina
Zdroj: Haematologica [Haematologica] 2023 Sep 01; Vol. 108 (9), pp. 2444-2453. Date of Electronic Publication: 2023 Sep 01.
DOI: 10.3324/haematol.2022.281375
Abstrakt: Grade (G) 3B follicular lymphoma (FL) is a rare FL subtype which exists on a histological continuum between 'lowgrade' (Grade 1, 2 and 3A FL) and diffuse large B-cell lymphoma (DLBCL) appearing to share features with each. Clinical characteristics and outcomes are poorly understood due to lack of adequate representation in prospective trials and large-scale analyses. We analyzed 157 G3BFL cases from 18 international centers, and two comparator groups; G3AFL (n=302) and DLBCL (n=548). Composite histology with DLBCL or low-grade FL occurred in approximately half of the G3BFL cases. With a median of 5 years follow-up, the overall survival and progression-free survival of G3BFL patients was better than that of DLBCL patients (P<0.001 and P<0.001, respectively); however, G3BFL patients were younger (P<0.001) with better performance status (P<0.001), less extranodal disease (P<0.001) and more frequently had normal lactate dehydrogenase (P<0.001) at baseline. The overall and progression-free survival of patients with G3BFL and G3AFL were similar (P=0.83 and P=0.80, respectively). After frontline immunochemotherapy, 24% of G3BFL relapsed; relapse rates were 63% in the DLBCL cohort and 19% in the low-grade FL cohort. Eight percent of relapses occurred beyond 5 years. In this G3BFL cohort, the revised International Prognostic Index successfully delineated risk groups, but the Follicular Lymphoma International Prognostic Index did not. We conclude that patients with immunochemotherapy-treated G3BFL have similar survival outcomes to those with G3AFL, yet a favorable baseline profile and distinctly superior prognosis compared to patients with DLBCL.
Databáze: MEDLINE