Follicular lymphoma in the modern era: Survival, treatment outcomes, and identification of high-risk subgroups Journal Article


Authors: Batlevi, C. L.; Sha, F.; Alperovich, A.; Ni, A.; Smith, K.; Ying, Z.; Soumerai, J. D.; Caron, P. C.; Falchi, L.; Hamilton, A.; Hamlin, P. A.; Horwitz, S. M.; Joffe, E.; Kumar, A.; Matasar, M. J.; Moskowitz, A. J.; Moskowitz, C. H.; Noy, A.; Owens, C.; Palomba, L. M.; Straus, D.; von Keudell, G.; Zelenetz, A. D.; Seshan, V. E.; Younes, A.
Article Title: Follicular lymphoma in the modern era: Survival, treatment outcomes, and identification of high-risk subgroups
Abstract: Patients with follicular lymphoma (FL) frequently require multiple treatments during their disease course; however, survival based on lines of treatment remains poorly described in the post-rituximab era. Also, the Follicular Lymphoma International Prognostic Index (FLIPI) score was developed to predict survival at diagnosis, yet it remains unknown whether increase in FLIPI score following an initial observation period is associated with less-favorable outcomes. To address these knowledge gaps, we retrospectively studied 1088 patients with FL grade 1–3A managed between 1998 and 2009 at our institution. Median overall survival (OS) and progression-free survival (PFS) after first-line treatment were not reached and 4.73 years, respectively. Following successive lines of treatment, years of median OS and PFS were, respectively: after second-line, 11.7 and 1.5; third-line, 8.8 and 1.1; fourth-line, 5.3 and 0.9; fifth-line, 3.1 and 0.6; sixth-line, 1.9 and 0.5. In initially observed, subsequently treated patients, FLIPI score increase after observation was associated with inferior survival following first-line treatment. The reduced survival we observed after second-line and later therapy supports the development of new treatments for relapsed patients and benchmarks historical targets for clinical endpoints. This study also highlights the utility of changes in FLIPI score at diagnosis and after observation in identifying patients likely to have worse outcomes. © 2020, The Author(s).
Keywords: adult; cancer survival; human tissue; treatment outcome; aged; cancer surgery; major clinical study; overall survival; systemic therapy; cancer patient; rituximab; cancer staging; outcome assessment; positron emission tomography; follow up; disease association; progression free survival; cancer survivor; bone marrow biopsy; high risk population; follicular lymphoma; marginal zone lymphoma; burkitt lymphoma; medical history; diffuse large b cell lymphoma; follicular lymphoma international prognostic index; human; male; female; article
Journal Title: Blood Cancer Journal
Volume: 10
ISSN: 2044-5385
Publisher: Nature Publishing Group  
Date Published: 2020-07-17
Start Page: 74
Language: English
DOI: 10.1038/s41408-020-00340-z
PUBMED: 32678074
PROVIDER: scopus
PMCID: PMC7366724
DOI/URL:
Notes: Article -- Export Date: 3 August 2020 -- Source: Scopus
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MSK Authors
  1. Venkatraman Ennapadam Seshan
    385 Seshan
  2. Craig Moskowitz
    407 Moskowitz
  3. Ariela Noy
    369 Noy
  4. Maria Lia Palomba
    442 Palomba
  5. Steven M Horwitz
    664 Horwitz
  6. Andrew D Zelenetz
    781 Zelenetz
  7. Alison Moskowitz
    355 Moskowitz
  8. Paul Hamlin
    291 Hamlin
  9. Matthew J Matasar
    292 Matasar
  10. Philip C Caron
    100 Caron
  11. David J Straus
    360 Straus
  12. Anita Kumar
    195 Kumar
  13. Connie Wing-Ching Lee Batlevi
    177 Batlevi
  14. Anas Younes
    320 Younes
  15. Colette Ngozi Owens
    78 Owens
  16. Zhitao   Ying
    6 Ying
  17. Ai   Ni
    99 Ni
  18. Erel Joffe
    84 Joffe
  19. Fushen Sha
    8 Sha
  20. Katy Charlotte Suzanne Smith
    4 Smith
  21. Lorenzo Falchi
    131 Falchi