The incidence of biopsy-proven transformation in follicular
lymphoma in the rituximab era. A retrospective analysis from
the Czech Lymphoma Study Group (CLSG) database

J 2018

The incidence of biopsy-proven transformation in follicular lymphoma in the rituximab era. A retrospective analysis from the Czech Lymphoma Study Group (CLSG) database

JANÍKOVÁ, Andrea, Zbyněk BORTLÍČEK, Vít CAMPR, Natasa KOPALOVA, Katerina BENESOVA et. al.

Basic information

Original name

The incidence of biopsy-proven transformation in follicular lymphoma in the rituximab era. A retrospective analysis from the Czech Lymphoma Study Group (CLSG) database

Authors

JANÍKOVÁ, Andrea (203 Czech Republic, guarantor, belonging to the institution), Zbyněk BORTLÍČEK (203 Czech Republic, belonging to the institution), Vít CAMPR (203 Czech Republic), Natasa KOPALOVA (203 Czech Republic), Katerina BENESOVA, Michaela HAMOUZOVA (203 Czech Republic), David BELADA (203 Czech Republic), Vit PROCHAZKA (203 Czech Republic), Robert PYTLIK (203 Czech Republic), Samuel VOKURKA (203 Czech Republic), Jan PIRNOS (203 Czech Republic), Juraj DURAS (203 Czech Republic), Heidi MOCIKOVA (203 Czech Republic), Jiří MAYER (203 Czech Republic, belonging to the institution) and Marek TRNENY (203 Czech Republic)

Edition

Annals of hematology, New York, Springer Verlag, 2018, 0939-5555

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30205 Hematology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.850

RIV identification code

RIV/00216224:14110/18:00104094

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s00277-017-3218-0

UT WoS

000426644800012

Keywords in English

Follicular lymphoma; Transformation; Rituximab

Abstract

V originále

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.

Citovat

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. 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.

@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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