De novo FL: long-term outcomes with grade 3A disease comparable to those with grades 1-2

  • Mercadal S & al.
  • Eur J Haematol
  • 26 Nov 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Among patients with de novo follicular lymphoma (FL) treated with first-line chemoimmunotherapy, those with histological grade 3A disease (G3A FL) have long-term outcomes comparable to those with grades 1-2 disease (G1-2FL).  

Why this matters

  • Compared with other histological grades in FL, less is known regarding the effect of grade 3 histology, particularly in the rituximab era.

Study design

  • Study to investigate the effect of histological grades in 250 patients with FL treated with first-line chemoimmunotherapy.
  • 188 patients had G1-2FL; 62 had G3A FL.
  • Funding: Instituto de Salud Carlos III.

Key results

  • In patients with G3A FL vs G1-2FL:
    • Estimated 6-year PFS: 56% (95% CI, 39%-73%) vs 55% (95% CI, 46%-63%; P=.782).
    • 6-year time to progression: 51% (95% CI, 41-61%) vs 57% (95% CI, 49-65%; P=.521).
    • Estimated 6-year OS probability: 76% (95% CI, 64%-88%) vs 83% (95% CI, 77%-89%; P=.044).
    • Cumulative incidence curves of death not related to lymphoma at 10 years: 0.26 (95% CI, 0.25-0.27) vs 0.05 (95% CI, 0.04-0.06).
    • No relapses were seen after 6 years in patients with G3A FL.

Limitations

  • Data for key molecular features not available.