Outcomes in grade 3B follicular lymphoma: an international study led by the Australasian Lymphoma Alliance

Barraclough, A; England, JT; Villa, D; Wight, J; Hapgood, G; Conn, J; Wong Doo, N; Li, EW; Gilbertson, M; Shaw, B; Bishton, MJ; Saeed, M; Ratnasingam, S; Abeyakoon, C; Chong, G; Wai, SH; Ku, M; Lee, HP; Fleming, K; Tam, C; Douglas, G; Cheah, CY; Ng, ZY; Rolfe, T; Mills, AK; Hamad, N; Cashman, H; Gleeson, M; Narayana, M; Hawkes, EA

Author(s): Barraclough, A; England, JT; Villa, D; Wight, J; Hapgood, G; Conn, J; Wong Doo, N; Li, EW; Gilbertson, M; Shaw, B; Bishton, MJ; Saeed, M; Ratnasingam, S; Abeyakoon, C; Chong, G; Wai, SH; Ku, M; Lee, HP; Fleming, K; Tam, C; Douglas, G; Cheah, CY; Ng, ZY; Rolfe, T; Mills, AK; Hamad, N; Cashman, H; Gleeson, M; Narayana, M; Hawkes, EA;
Details: Publication Year 2023-09-01,Volume 108,Issue #9,Page 2444-2453
Journal Title: Haematologica
Publication Type: Research article
Abstract: Grade (G) 3B follicular lymphoma (FL) is a rare FL subtype which exists on a histological continuum between 'lowgrade' (Grade 1, 2 and 3A FL) and diffuse large B-cell lymphoma (DLBCL) appearing to share features with each. Clinical characteristics and outcomes are poorly understood due to lack of adequate representation in prospective trials and large-scale analyses. We analyzed 157 G3BFL cases from 18 international centers, and two comparator groups; G3AFL (n=302) and DLBCL (n=548). Composite histology with DLBCL or low-grade FL occurred in approximately half of the G3BFL cases. With a median of 5 years follow-up, the overall survival and progression-free survival of G3BFL patients was better than that of DLBCL patients (P<0.001 and P<0.001, respectively); however, G3BFL patients were younger (P<0.001) with better performance status (P<0.001), less extranodal disease (P<0.001) and more frequently had normal lactate dehydrogenase (P<0.001) at baseline. The overall and progression-free survival of patients with G3BFL and G3AFL were similar (P=0.83 and P=0.80, respectively). After frontline immunochemotherapy, 24% of G3BFL relapsed; relapse rates were 63% in the DLBCL cohort and 19% in the low-grade FL cohort. Eight percent of relapses occurred beyond 5 years. In this G3BFL cohort, the revised International Prognostic Index successfully delineated risk groups, but the Follicular Lymphoma International Prognostic Index did not. We conclude that patients with immunochemotherapy-treated G3BFL have similar survival outcomes to those with G3AFL, yet a favorable baseline profile and distinctly superior prognosis compared to patients with DLBCL.
Publisher: Ferrata-Storti Foundation
Keywords: Humans; *Lymphoma, Follicular/diagnosis/drug therapy; Prospective Studies; Neoplasm Recurrence, Local; *Lymphoma, Non-Hodgkin/pathology; Prognosis; *Lymphoma, Large B-Cell, Diffuse/diagnosis/drug therapy
Department(s): Clinical Haematology
PubMed ID: 36815381
Publisher's Version: https://doi.org/10.3324/haematol.2022.281375
Open Access at Publisher's Site: https://doi.org/10.3324/haematol.2022.281375
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-11-14 03:57:54

Last Modified: 2023-11-14 03:58:49