Outcome of extra-nodal follicular lymphoma affected by choice of induction chemoimmunotherapy and maintenance rituximab – real-world retrospective study

作者：Lawrence Cheng Kiat Ng, Shin Yeu Ong, Xinxin Huang, Aditi Ghosh, Chandramouli Nagarajan, Yeow Tee Goh, Yunxin Chen, Francesca Lim, Melinda Si Yun Tan, Xiu Hue Lee, Jing Yuan Tan, Nicholas F. Grigoropoulos, Valerie Shiwen Yang, Joshua Tian Ming Hoe, Jianbang Chiang, Esther Wei Yin Chang, Eileen Poon, Ya Hwee Tan, Nagavalli Somasundaram, Miriam Tao, Soon Thye Lim, Jason Yongsheng Chan · 发表于：Leukemia & lymphoma/Leukemia and lymphoma · 年份：2024 · DOI：10.1080/10428194.2024.2446615 · 被引用次数：1 · 研究领域：Lymphoma Diagnosis and Treatment、Viral-associated cancers and disorders、CNS Lymphoma Diagnosis and Treatment

The importance of extra-nodal disease has been well recognized in follicular lymphoma, and is incorporated into various prognostic tools. However, the optimal treatment strategy for this subgroup remains unclear. In this multicenter retrospective study, we analyzed 143 patients who received either R-CHOP or Bendamustine-Rituximab (BR), with a median follow-up of 69.7 months. Our findings indicate that extra-nodal disease confers poorer PFS (5-year PFS 58% vs 66%, p = 0.03) while high-risk relapse predict poorer OS (5-year OS 56% vs 94%, p < 0.001). Subgroup analysis on 98 patients with extra-nodal disease revealed that BR induction conferred superior PFS compared to R-CHOP (HR 0.49, p = 0.032) while maintenance rituximab also improved PFS (HR 0.44, p = 0.033). Patients who received R-CHOP without maintenance rituximab had significantly worse PFS (5-year PFS 41% vs 68%, p = 0.005) and OS (5-year OS 83% vs 100%, p = 0.007) compared to those with maintenance rituximab. Role of maintenance rituximab post BR remained unclear. In this retrospective study of follicular lymphoma patients with extra-nodal disease, BR induction yielded favorable PFS compared to R-CHOP and could be a preferred treatment approach. Maintenance rituximab after R-CHOP significantly improve PFS and OS and should be considered in all appropriate patients.