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Frontline intensive chemotherapy improves outcome in young, high-risk patients with follicular lymphoma: pair-matched analysis from the Czech Lymphoma Study Group Database.
- Source :
-
Leukemia & Lymphoma . Mar2017, Vol. 58 Issue 3, p601-613. 13p. - Publication Year :
- 2017
-
Abstract
- Optimal frontline treatment in younger high tumor-burden risk follicular lymphoma patients remains a challenge given the reduced efficacy of standard immunochemotherapy (R-CHOP) in widespread disease and unclear role of intensive induction. The retrospective non-randomized pair-matched (1:3) analysis compared 48 intermediate/high Follicular Lymphoma International Prognostic Index (FLIPI) patients receiving intensive rituximab sequential chemotherapy (R-SQ) with 144 random controls (R-CHOP) matched for age, FLIPI score, and maintenance delivery. Complete response rates were 91.7% and 74.1%, respectively (p = .038). After a median follow-up of 8.8 (R-SQ) and 6.5 years (R-CHOP), 5-year time to treatment failure, progression-free survival, and overall survival were 80.9%, 83.2%, and 100% and 57.5%, 60.3%, and 92.1% (p = .0044;p = .0047;p = .22), respectively. Intensive treatment was accompanied by higher acute hematologic toxicity and infections, comparable non-hematologic toxicity, and incidence of secondary malignancies. Intensive induction demonstrates superior long-term disease control compared to R-CHOP, with higher acute hematologic toxicity, but without acute treatment-related mortality. Further studies are needed to define ultra-high-risk FL patients benefiting most from treatment intensity. [ABSTRACT FROM PUBLISHER]
- Subjects :
- *LYMPHOMA treatment
*AUTOTRANSPLANTATION
*CANCER chemotherapy
*PROGNOSIS
*RITUXIMAB
Subjects
Details
- Language :
- English
- ISSN :
- 10428194
- Volume :
- 58
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Leukemia & Lymphoma
- Publication Type :
- Academic Journal
- Accession number :
- 120859634
- Full Text :
- https://doi.org/10.1080/10428194.2016.1213834