TY - JOUR
T1 - Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma
AU - Sha, Fushen
AU - Okwali, Michelle
AU - Alperovich, Anna
AU - Caron, Philip C.
AU - Falchi, Lorenzo
AU - Hamilton, Audrey
AU - Hamlin, Paul A.
AU - Horwitz, Steven M.
AU - Joffe, Erel
AU - Khan, Niloufer
AU - Kumar, Anita
AU - Matasar, Matthew J.
AU - Moskowitz, Alison J.
AU - Noy, Ariela
AU - Owens, Colette
AU - Palomba, Lia M.
AU - Rodriguez-Rivera, Ildefonso
AU - Straus, David
AU - von Keudell, Gottfried
AU - Zelenetz, Andrew D.
AU - Yahalom, Joachim
AU - Dogan, Ahmet
AU - Schöder, Heiko
AU - Seshan, Venkatraman E.
AU - Salles, Gilles
AU - Younes, Anas
AU - Batlevi, Connie L.
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/2
Y1 - 2022/2
N2 - Between 1998 and 2009, a total of 295 patients (median age 58, 53% females) with newly diagnosed early-stage follicular lymphoma (FL) were managed at Memorial Sloan Kettering Cancer Center. Approximately half of patients (137, 46%) underwent initial observation and half (158, 54%) immediate treatment: radiation alone (n = 108), systemic treatment alone (n = 29), or combined modality treatment (n = 21). Median follow-up was 8.4 years (range 0.3–17.2), and 10-year overall survival (OS) was 87.2%. OS was similar between initially-observed and immediately-treated patients (hazard ratio [HR]: 1.25, 95% CI: 0.67–2.36, p = 0.49). For patients receiving radiation alone, 5-year OS was 98.0%. Patients selected for systemic therapy alone had high-risk baseline features and had shorter OS than patients treated with radiation alone (HR 3.38, 95% CI 1.29–8.86, p = 0.01). Combined modality treatment did not yield superior survival compared with radiation alone (P > 0.05) but was associated with better progression-free survival (HR 0.36, 95% CI 0.14–0.90, p = 0.03). The rate of transformation increased steadily over time and was 4.2% at 5 years and 10.8% at 10 years. This modern-era analysis rationalized the role of initial observation in patients with early-stage FL although patients receiving radiation therapy also demonstrate excellent outcome.
AB - Between 1998 and 2009, a total of 295 patients (median age 58, 53% females) with newly diagnosed early-stage follicular lymphoma (FL) were managed at Memorial Sloan Kettering Cancer Center. Approximately half of patients (137, 46%) underwent initial observation and half (158, 54%) immediate treatment: radiation alone (n = 108), systemic treatment alone (n = 29), or combined modality treatment (n = 21). Median follow-up was 8.4 years (range 0.3–17.2), and 10-year overall survival (OS) was 87.2%. OS was similar between initially-observed and immediately-treated patients (hazard ratio [HR]: 1.25, 95% CI: 0.67–2.36, p = 0.49). For patients receiving radiation alone, 5-year OS was 98.0%. Patients selected for systemic therapy alone had high-risk baseline features and had shorter OS than patients treated with radiation alone (HR 3.38, 95% CI 1.29–8.86, p = 0.01). Combined modality treatment did not yield superior survival compared with radiation alone (P > 0.05) but was associated with better progression-free survival (HR 0.36, 95% CI 0.14–0.90, p = 0.03). The rate of transformation increased steadily over time and was 4.2% at 5 years and 10.8% at 10 years. This modern-era analysis rationalized the role of initial observation in patients with early-stage FL although patients receiving radiation therapy also demonstrate excellent outcome.
UR - http://www.scopus.com/inward/record.url?scp=85124446447&partnerID=8YFLogxK
U2 - 10.1038/s41408-022-00620-w
DO - 10.1038/s41408-022-00620-w
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 35145059
AN - SCOPUS:85124446447
SN - 2044-5385
VL - 12
JO - Blood Cancer Journal
JF - Blood Cancer Journal
IS - 2
M1 - 29
ER -