| Autor: |
Joshua W.D. Tobin, Gabrielle Rule, Katherine Colvin, Lourdes Calvente, David Hodgson, Stephen Bell, Chengetai Dunduru, James Gallo, Erica S. Tsang, Xuan Tan, Jonathan Wong, Jessica Pearce, Robert Campbell, Shao Tneh, Sophie Shorten, Melissa Ng, Tara Cochrane, Constantine S. Tam, Emad Abro, Eliza Hawkes, Georgina Hodges, Roopesh Kansara, Dipti Talaulikar, Michael Gilbertson, Anna M. Johnston, Kerry J. Savage, Diego Villa, Kirk Morris, Sumi Ratnasingam, Wojt Janowski, Robert Kridel, Chan Y. Cheah, Michael MacManus, Nicholas Matigian, Peter Mollee, Maher K. Gandhi, Greg Hapgood |
| Jazyk: |
angličtina |
| Rok vydání: |
2019 |
| Předmět: |
|
| Zdroj: |
Blood Advances, Vol 3, Iss 19, Pp 2804-2811 (2019) |
| Druh dokumentu: |
article |
| ISSN: |
2473-9529 |
| DOI: |
10.1182/bloodadvances.2019000458 |
| Popis: |
Abstract: Management practices in early-stage (I/II) follicular lymphoma (FL) are variable and include radiation (RT), systemic therapy, or combined modality therapy (CMT). There is a paucity of data regarding maintenance rituximab in this cohort. We conducted an international retrospective study of patients with newly diagnosed early-stage FL staged with positron emission tomography (PET)–computed tomography and bone marrow biopsy. Three hundred sixty-five patients (stage I, n = 221), median age 63 years, treated from 2005-2017 were included, with a median follow-up of 45 months. Management included watchful waiting (WW; n = 85) and active treatment (n = 280). The latter consisted of RT alone (n = 171) or systemic therapy (immunochemotherapy [n = 63] or CMT [n = 46]). Forty-nine systemically treated patients received maintenance rituximab; 72.7% of stage I patients received RT alone, compared to 42.6% with stage II (P < .001). Active therapies yielded comparable overall response rates (P = .87). RT alone and systemic therapy without maintenance rituximab yielded similar progression-free survival (PFS) (hazard ratio [HR], 1.32; 95% confidence interval [CI], 0.77-2.34; P = .96). Maintenance rituximab improved PFS (HR, 0.24; 95% CI, 0.095-0.64; P = .017). The incidence of transformation was lower with systemic therapy compared to RT or WW (HR, 0.20; 95% CI, 0.070-0.61; P = .034). Overall survival was similar among all practices, including WW (P = .40). In the largest comparative assessment of management practices in the modern era, variable practices each resulted in similar excellent outcomes. Randomized studies are required to determine the optimal treatment in early-stage FL. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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