Eur J Cancer: Poor prognosis and high tissue transformation rate of primary refractory follicular lymphoma

The clinical course of primary refractory (PREF) follicular lymphoma (FL) is completely different from that of follicular lymphoma that responds to first-line treatment
.

In addition to poor response to salvage treatment, patients with primary refractory follicular lymphoma appear to be at increased risk of tissue transformation (HT)

Lymphoma

The Aristotle Consortium provides an opportunity to investigate the risk of tissue transformation in a large-scale case of primary refractory follicular lymphoma
.

Sara et al.

This analysis included 6339 patients in the Aristotle database.
These patients were grade 1, grade 2, or grade 3a follicular lymphoma diagnosed histologically from 1997 to 2013
.

The primary endpoint is the cumulative incidence (CI) of tissue transformation at the time of first progression or recurrence, and the survival prognosis after transformation

Cumulative incidence of tissue transformation in different groups of patients

Cumulative incidence of tissue transformation in different groups of patients

The 5-year cumulative incidence of tissue transformation of patients in the primary refractory follicular lymphoma group was 34% (95% CI 27-43), while the rate of partial remission (PR) or stable disease (SD) in the treatment group was 34% (95% CI 27-43).
The 5-year cumulative incidence of tissue transformation was 7.
1% (95% CI 6.
0-8.
5), and the incidence of patients who achieved complete remission (CR) was only 3.
5% (95% CI 3.
0-4.
2)
.

The 5-year cumulative incidence of tissue transformation of patients in the primary refractory follicular lymphoma group was 34% (95% CI 27-43), while the rate of partial remission (PR) or stable disease (SD) in the treatment group was 34% (95% CI 27-43).
The 5-year cumulative incidence of tissue transformation was 7.
1% (95% CI 6.
0-8.
5), and the incidence of patients who achieved complete remission (CR) was only 3.
5% (95% CI 3.
0-4.
2)
.

The 5-year cumulative incidence of tissue transformation of patients in the primary refractory follicular lymphoma group was 34% (95% CI 27-43), while the rate of partial remission (PR) or stable disease (SD) in the treatment group was 34% (95% CI 27-43).

Survival rate of patients with different responses to induction therapy after relapse

Survival rate of patients with different responses to induction therapy after relapse

The 5-year survival rates after recurrence after first-line treatment in the primary refractory follicular lymphoma group, PR group, and SD group were 33% (95% CI 28-39), 57% (54-61), and 51%, respectively (43-58), the 5-year survival rate of patients who achieved complete remission after initial treatment was 63% (95% CI 66-72; p<0.
001)
.

The 5-year survival rates after recurrence after first-line treatment in the primary refractory follicular lymphoma group, PR group, and SD group were 33% (95% CI 28-39), 57% (54-61), and 51%, respectively (43-58), the 5-year survival rate of patients who achieved complete remission after initial treatment was 63% (95% CI 66-72; p<0.
001)
.

Survival rate of patients with primary refractory follicular lymphoma with or without tissue transformation

Survival rate of patients with primary refractory follicular lymphoma with or without tissue transformation

The 5-year survival rate of patients with primary refractory follicular lymphoma that has undergone tissue transformation is 21% (95% CI 12-31) after recurrence, which is comparable to that of primary refractory follicular lymphoma that has not undergone tissue transformation.

The 5-year survival rate of patients with primary refractory follicular lymphoma that has undergone tissue transformation is 21% (95% CI 12-31) after recurrence, which is comparable to that of primary refractory follicular lymphoma that has not undergone tissue transformation.

The prognosis of patients with primary refractory follicular lymphoma is poor, and the high tissue transformation rate makes the poor prognosis worse, which makes the prognosis of patients with primary refractory follicular lymphoma worse.

Original source:

Alonso-álvarez Sara,Manni Martina,Montoto Silvia et al.

Primary refractory follicular lymphoma: a poor outcome entity with high risk of transformation to aggressive B cell lymphoma in this message