title: Transformed follicular lymphoma: the 25-year experience of a UK provincial lymphoma treatment centre.
abstract: Follicular lymphoma can transform into diffuse large B cell lymphoma, which is usually associated with rapid disease progression, refractoriness to treatment and a poor outcome. We report the 25-year unselected experience of a UK provincial lymphoma treatment centre. This comprises of one of the largest series ever studied. Sixty-three patients were identified (56 initially presented as follicular lymphoma, 5 with 'transformed' lymphoma and 2 with follicular and transformed lymphoma from different biopsy sites). The median age at presentation was 54 years (range 32-76). The median time to transformation was 43 months (range 0-172). For all patients, the median overall survival was 76 months (range 8-254) and from transformation 10 months (range 1-166); 46 of 63 patients have died. For those whose transformation was initially treated with CHOP chemotherapy 10 were in complete remission (CR) and 14 were deceased (median survival 24, range 2-114 months). Five patients had high-dose chemotherapy and 3 were alive (at 25, 36 and 137 months). We conclude that CHOP chemotherapy (probably with rituximab) is a reasonable first treatment in fit patients and high dose chemotherapy with autologous stem cell support deserves further study.
authors.affiliation: YCR Academic Unit of Clinical Oncology, Weston Park Hospital, Sheffield, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Morley
authors.forename: L S
authors.initials: LS
authors.lastname: Evans
authors.forename: J
authors.initials: J
authors.lastname: Goepel
authors.forename: B W
authors.initials: BW
authors.lastname: Hancock
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone