Real world data on histological transformation in patients with follicular lymphoma: incidence, clinico-pathological risk factors and outcome in a nationwide Danish cohort. Issue 11 (18th September 2020)

• Record Type: Journal Article
• Authors: Madsen, Charlotte; Plesner, Trine Lindhardt; Bentzen, Hans Herluf; Jørgensen, Judit; Sillesen, Ida Blok; Himmelstrup, Bodil M.; Josefsson, Pär; Plesner, Torben; Bennedsen, Tine Litske; Ludvigsen, Maja; d'Amore, Francesco A.
• Is Part Of: Leukemia & lymphoma. Volume 61:Issue 11(2020)
• Page Start: 2584
• Page End: 2594
• Publication Date: 2020-09-18
• Subjects: Rituximab era -- follicular lymphoma -- transformation; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2020.1779254
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: We investigated incidence, risk factors and outcome for follicular lymphoma (FL) patients with histologic transformation (HT) found at primary diagnosis (discordant/composite, dc-tFL) or sequentially (s-tFL). Between 2000 and 2015, 2773 patients were identified. The majority of patients (2252, 81%) did not experience HT (nt-FL), while 224 (8%) had dc-tFL and 297 (11%) s-tFL. The risk of HT was 2.2% per year and 9.6% at 5 years. Age ≥60, a high FLIPI risk score and LDH-elevation were associated with increased risk of HT. Calculated from primary diagnosis and compared with nt-FL, 5-year overall survival (OS) was inferior in both s-tFL and dc-tFL (nt-FL: 82%, s-tFL: 68%, dc-tFL: 68%; p = .001), whereas 5-year progression-free survival (PFS) was worse only in s-tFL (s-tFL: 18%, dc-tFL: 58%, nt-FL: 60%). Calculated from time of HT, s-tFL had inferior outcome compared to dc-tFL for both OS (s-tFL: 47%, dc-tFL: 68%, p = .001) and PFS (s-tFL: 35%, dc-tFL: 58%, p = .001).