Does follicularity in large cell lymphoma predict outcome after autologous stem cell transplantation?
The purpose of this study was to evaluate whether follicular histology in large cell lymphoma influences treatment outcomes after autologous stem cell transplantation (ASCT). It remains an area of controversy whether the natural history of follicular large cell lymphoma (FLCL) is akin to diffuse large cell lymphoma (DLCL) with curative potential or is more similar to indolent follicular lymphomas with a pattern of late relapses after intensive chemotherapy. Although ASCT is a potentially curative treatment for patients with recurrent DLCL, the effectiveness of this approach in patients with FLCL is unclear. We undertook a retrospective analysis of 332 patients with large cell lymphoma who underwent ASCT at the City of Hope Comprehensive Cancer Center. With a median follow-up of 31 months, the projected 10-year overall survival and disease-free survival were similar between patients with FLCL and DLCL. Analysis of prognostic factors demonstrated that although age, chemotherapy refractoriness, and disease status at the time of ASCT were predictive of overall survival/disease-free survival, follicularity did not influence the outcome. Furthermore, the similar plateau in the survival curve for the DLCL and FLCL patients suggests that the behavior of FLCL is similar to that of DLCL and that FLCL is potentially curable with ASCT.
Krishnan
Amrita
A
Division of Hematology/Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California 91010, USA. akrishnan@coh.org
Nademanee
Auayporn
A
Fung
Henry
H
Angelopoulou
Maria
M
Molina
Arturo
A
Gaal
Karl
K
Dagis
Andrew
A
Palmer
Joycelynne
J
Alvarnas
Joseph
J
Slovak
Marilyn
M
Kogut
Neil
N
Popplewell
Leslie
L
Rodriguez
Roberto
R
Schriber
Jeffrey
J
Wang
Sean
S
Forman
Stephen J
SJ
D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome