Impact and utility of follicular lymphoma GELF criteria in routine care: an Australasian Lymphoma Alliance study

Barraclough, A; Agrawal, S; Talaulikar, D; Chong, G; Yoo, E; Cheah, CY; Franco, N; Nguyen, B; Mutsando, H; Tahir, F; Trotman, J; Huang, J; Keane, C; Lincoln, M; Cochrane, T; Johnston, AM; Dickinson, M; Opat, S; McQuilten, ZK; Wood, EM; St George, G; Hawkes, EA

Author(s): Barraclough, A; Agrawal, S; Talaulikar, D; Chong, G; Yoo, E; Cheah, CY; Franco, N; Nguyen, B; Mutsando, H; Tahir, F; Trotman, J; Huang, J; Keane, C; Lincoln, M; Cochrane, T; Johnston, AM; Dickinson, M; Opat, S; McQuilten, ZK; Wood, EM; St George, G; Hawkes, EA;
Details: Publication Year 2024-10-01,Volume 109,Issue #10,Page 3338-3345
Journal Title: Haematologica
Publication Type: Research article
Abstract: Follicular lymphoma (FL) treatment initiation is largely determined by tumor burden and symptoms. In the pre-rituximab era, the Group d'Etude des Lymphomes Folliculaires (GELF) developed widely adopted criteria to identify high tumor burden FL patients to harmonize clinical trial populations. The utilization of GELF criteria (GELFc) in routine therapeutic decision- making is poorly described. This multicenter retrospective study evaluated patterns of GELFc at presentation and GELFc utilization in therapeutic decision-making in newly diagnosed, advanced-stage rituximab-era FL. Associations between GELFc, treatment given, and patient survival were analyzed in 300 eligible cases identified between 2002-2019. One hundred and sixty-three (54%) had ≥1 GELFc at diagnosis. The presence or cumulative number of GELFc did not predict progression-free survival in patients undergoing watch-and-wait (W&W) or those receiving systemic treatment. Of interest, in patients with ≥1 GELFc, 16 of 163 (10%) underwent initial W&W (comprising 22% of the W&W cohort). In those receiving systemic therapy +/- radiotherapy, 74 of 215 (34%) met no GELFc. Our data suggest clinicians are using adjunctive measures to make decisions regarding treatment initiation in a significant proportion of patients. By restricting FL clinical trial eligibility only to those meeting GELFc, reported outcomes may not be applicable to a significant proportion of patients treated in routine care settings.
Publisher: Ferrata-Storti Foundation
Keywords: Humans; *Lymphoma, Follicular/therapy/mortality/diagnosis/pathology; Male; Female; Middle Aged; Aged; Retrospective Studies; Adult; Aged, 80 and over; Rituximab/therapeutic use; Neoplasm Staging; Tumor Burden; Prognosis; Australasia/epidemiology; Clinical Decision-Making
Department(s): Clinical Haematology
Publisher's Version: https://doi.org/10.3324/haematol.2023.284538
Open Access at Publisher's Site: https://doi.org/10.3324/haematol.2023.284538
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-03 03:37:14

Last Modified: 2024-10-03 03:37:33