title: Outcomes for transformed follicular lymphoma in the rituximab era: the Royal Marsden experience 2003-2013.
abstract: Survival for transformed follicular lymphoma (tFL) has improved in the rituximab era and the need for upfront stem cell transplantation (SCT) is unclear. We evaluated the outcomes for all patients treated with first-line chemotherapy for histologically-proven tFL at our institution from 2003-2013 (n = 87). The majority of patients (89.7%) did not receive a SCT as part of first-line management. With a median follow-up of 7.8 years the 5-year overall survival (OS) for all patients was 61.7%. Patients treated with R-CHOP without upfront SCT (n = 55/87) had a 5-year OS of 64.3%. In a Cox regression analysis of the entire cohort (n = 87) International Prognostic Index (IPI) risk group and presence of B symptoms at transformation were independently associated with OS in multivariate analysis (MVA). Our analysis confirms the improved survival of tFL in the rituximab era even in the absence of upfront SCT consolidation.
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Mary
authors.initials: M
authors.lastname: Gleeson
authors.affiliation: b Department of Oncology and Clinical Haematology , Austin Health , Heidelberg , Melbourne , Australia.|c Eastern Health , Melbourne , Australia.
authors.forename: Eliza A
authors.initials: EA
authors.lastname: Hawkes
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Clare
authors.initials: C
authors.lastname: Peckitt
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wotherspoon
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Ayoma
authors.initials: A
authors.lastname: Attygalle
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Bhupinder
authors.initials: B
authors.lastname: Sharma
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Yong
authors.initials: Y
authors.lastname: Du
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Ethell
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Mike
authors.initials: M
authors.lastname: Potter
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Dearden
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Horwich
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: Chau
authors.affiliation: a The Royal Marsden Hospital, London and Surrey , United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000074322:Antineoplastic Agents, Immunological / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012074:Remission Induction; D000069283:Rituximab / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000074322:Antineoplastic Agents, Immunological; D000069283:Rituximab
keywords: Follicular lymphoma; high-grade transformation; rituximab era; stem-cell transplantation