Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/21877
Title: Outcomes of stage I/II follicular lymphoma in the PET era: an international study from the Australian Lymphoma Alliance.
Austin Authors: Tobin, Joshua W D;Rule, Gabrielle;Colvin, Katherine;Calvente, Lourdes;Hodgson, David;Bell, Stephen;Dunduru, Chengetai;Gallo, James;Tsang, Erica S;Tan, Xuan;Wong, Jonathan;Pearce, Jessica;Campbell, Robert;Tneh, Shao;Shorten, Sophie;Ng, Melissa;Cochrane, Tara;Tam, Constantine S;Abro, Emad;Hawkes, Eliza A ;Hodges, Georgina;Kansara, Roopesh;Talaulikar, Dipti;Gilbertson, Michael;Johnston, Anna M;Savage, Kerry J;Villa, Diego;Morris, Kirk;Ratnasingam, Sumi;Janowski, Wojt;Kridel, Robert;Cheah, Chan Y;MacManus, Michael;Matigian, Nicholas;Mollee, Peter;Gandhi, Maher K;Hapgood, Greg
Affiliation: Department of Clinical Haematology, Austin Health, Heidelberg, Victoria, Australia
Department of Haematology, Princess Alexandra Hospital, Brisbane, QLD, Australia
QFAB Bioinformatics, Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
Department of Haematology, Sir Charles Gairdner Hospital, Perth, WA, Australia
Department of Haematology, Andrew Love Cancer Centre, University Hospital Geelong, Geelong, Victoria, Australia
Department of Haematology, Royal Brisbane Hospital, Brisbane, QLD, Australia
Department of Haematology, Royal Hobart Hospital, Hobart, TAS, Australia
Department of Clinical Haematology, Monash Health, Melbourne, Victoria, Australia
Department of Haematology, Canberra Hospital, Canberra, ACT, Australia
Department of Haematology, Townsville Hospital, Townsville, QLD, Australia
Department of Oncology, Austin Health, Heidelberg, Victoria, Australia
Department of Haematology, Mater Hospital Brisbane, Brisbane, QLD, Australia
Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia
Department of Haematology, Gold Coast University Hospital, Gold Coast, QLD, Australia
Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Department of Haematology, Calvary Mater Health, Newcastle, NSW, Australia
Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada
Division of Medical Oncology, BC Cancer, Vancouver, BC, Canada
Section of Medical Oncology and Haematology, University of Manitoba, Winnipeg, MB, Canada
Division of Medical Oncology, BC Cancer, Vancouver, BC, Canada
Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada
Issue Date: 8-Oct-2019
Publication information: Blood advances 2019; 3(19): 2804-2811
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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/21877
DOI: 10.1182/bloodadvances.2019000458
ORCID: 0000-0003-2974-8023
0000-0002-0376-2559
0000-0002-4625-3009
0000-0003-0287-7124
0000-0002-0900-5815
0000-0001-7735-9415
0000-0003-1000-5393
PubMed URL: 31570492
Type: Journal Article
Appears in Collections:Journal articles

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