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@article{1451657,
author = {Janíková, Andrea and Bortlíček, Zbyněk and Campr, Vít and Kopalova, Natasa and Benesova, Katerina and Hamouzova, Michaela and Belada, David and Prochazka, Vit and Pytlik, Robert and Vokurka, Samuel and Pirnos, Jan and Duras, Juraj and Mocikova, Heidi and Mayer, Jiří and Trneny, Marek},
article_location = {New York},
article_number = {4},
doi = {http://dx.doi.org/10.1007/s00277-017-3218-0},
keywords = {Follicular lymphoma; Transformation; Rituximab},
language = {eng},
issn = {0939-5555},
journal = {Annals of hematology},
title = {The incidence of biopsy-proven transformation in follicular lymphoma in the rituximab era. A retrospective analysis from the Czech Lymphoma Study Group (CLSG) database},
volume = {97},
year = {2018}
}
TY - JOUR
ID - 1451657
AU - Janíková, Andrea - Bortlíček, Zbyněk - Campr, Vít - Kopalova, Natasa - Benesova, Katerina - Hamouzova, Michaela - Belada, David - Prochazka, Vit - Pytlik, Robert - Vokurka, Samuel - Pirnos, Jan - Duras, Juraj - Mocikova, Heidi - Mayer, Jiří - Trneny, Marek
PY - 2018
TI - The incidence of biopsy-proven transformation in follicular lymphoma in the rituximab era. A retrospective analysis from the Czech Lymphoma Study Group (CLSG) database
JF - Annals of hematology
VL - 97
IS - 4
SP - 669-678
EP - 669-678
PB - Springer Verlag
SN - 09395555
KW - Follicular lymphoma
KW - Transformation
KW - Rituximab
N2 - The aim of this study is to assess the incidence, risk factors, and outcome of biopsy-proven transformation in follicular lymphoma (FL) patients in the rituximab era. Transformation was analyzed in 1233 patients with initially diagnosed FL grades 1-3A, identified between 2002 and 2012 in the prospectively maintained Czech Lymphoma Study Group database. Only patients with histologically proven transformation (HT) were included. HT occurred in 58 cases at a median of 3.0 years from the initial FL diagnosis; the HT rate was 4% at 5 years. Transformation occurred most frequently at the first relapse (84% patients). Median OS from the HT was 2.5 years (95% CI 0.4-4.6) and 6-year OS with HT was shorter compared to all FLs (60 vs. 83.9%; 95% CI). A bulky tumor (>= 10 cm), increased lactate dehydrogenase, age >= 60 years, and International Prognostic Index (intermediate/high risk), but not Follicular Lymphoma International Prognostic Index, were associated with transformation (p < 0.05). In the first line, 70% of patients received rituximab (including 36% rituximab maintenance), 57% CHOP-like regimens, and 2.6% of patients were treated with fludarabine-based therapy, whereas 11% of patients were watched only. The patients treated with R-CHOP in the first line (n = 591) showed the transformation rate at 5 years of 4.23% (95% CI 2.52-5.93); subsequent rituximab maintenance (n = 276) vs. observation (n = 153) was associated with a lower transformation rate (p.033; HR 3.29; CI 1.10-9.82). The transformation rate seems to be lower than in previous series, which may be influenced by broad use of rituximab, but prognosis of HT developed during therapy continues to be poor.
ER -
JANÍKOVÁ, Andrea, Zbyněk BORTLÍČEK, Vít CAMPR, Natasa KOPALOVA, Katerina BENESOVA, Michaela HAMOUZOVA, David BELADA, Vit PROCHAZKA, Robert PYTLIK, Samuel VOKURKA, Jan PIRNOS, Juraj DURAS, Heidi MOCIKOVA, Jiří MAYER and Marek TRNENY. The incidence of biopsy-proven transformation in follicular lymphoma in the rituximab era. A retrospective analysis from the Czech Lymphoma Study Group (CLSG) database. \textit{Annals of hematology}. New York: Springer Verlag, 2018, vol.~97, No~4, p.~669-678. ISSN~0939-5555. Available from: https://dx.doi.org/10.1007/s00277-017-3218-0.
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