PURPOSE: To study the clinical significance of transformation to diffuse large B-cell lymphoma (DLBCL) in patients with follicular lymphoma (FL). PATIENTS AND METHODS: From 1972 to 1999, 325 patients were diagnosed with FL at St Bartholomew's Hospital (London, United Kingdom). With a median follow-up of 15 years, progression occurred in 186 patients and biopsy-proven transformation in 88 of the 325. The overall repeat biopsy rate was 70%. RESULTS: The risk of histologic transformation (HT) by 10 years was 28%, HT not yet having been observed after 16.2 years. The risk was higher in patients with advanced stage (P = .02), high-risk Follicular Lymphoma International Prognostic Index (FLIPI; P = .01), and International Prognostic Index (IPI; P = .04) scores at diagnosis. Expectant management (as opposed to treatment being initiated at diagnosis) also predicted for a higher risk of HT (P = .008). Older age (P = .005), low hemoglobin level (P = .03), high lactate dehydrogenase (P < .0001), and high-risk FLIPI (P = .01) or IPI (P = .003) score at the time of first recurrence were associated with the diagnosis of HT in a biopsy performed at that time. The median survival from transformation was 1.2 years. Patients with HT had a shorter overall survival (P < .0001) and a shorter survival from progression (P < .0001) than did those in whom it was not diagnosed. CONCLUSION: Advanced stage and high-risk FLIPI and IPI scores at diagnosis correlate with an increased risk of HT. This event strongly influences the outcome of patients with FL by shortening their survival. There may be a subgroup of patients in whom HT does not occur.
PURPOSE: To study the clinical significance of transformation to diffuse large B-cell lymphoma (DLBCL) in patients with follicular lymphoma (FL). PATIENTS AND METHODS: From 1972 to 1999, 325 patients were diagnosed with FL at St Bartholomew's Hospital (London, United Kingdom). With a median follow-up of 15 years, progression occurred in 186 patients and biopsy-proven transformation in 88 of the 325. The overall repeat biopsy rate was 70%. RESULTS: The risk of histologic transformation (HT) by 10 years was 28%, HT not yet having been observed after 16.2 years. The risk was higher in patients with advanced stage (P = .02), high-risk Follicular Lymphoma International Prognostic Index (FLIPI; P = .01), and International Prognostic Index (IPI; P = .04) scores at diagnosis. Expectant management (as opposed to treatment being initiated at diagnosis) also predicted for a higher risk of HT (P = .008). Older age (P = .005), low hemoglobin level (P = .03), high lactate dehydrogenase (P < .0001), and high-risk FLIPI (P = .01) or IPI (P = .003) score at the time of first recurrence were associated with the diagnosis of HT in a biopsy performed at that time. The median survival from transformation was 1.2 years. Patients with HT had a shorter overall survival (P < .0001) and a shorter survival from progression (P < .0001) than did those in whom it was not diagnosed. CONCLUSION: Advanced stage and high-risk FLIPI and IPI scores at diagnosis correlate with an increased risk of HT. This event strongly influences the outcome of patients with FL by shortening their survival. There may be a subgroup of patients in whom HT does not occur.
Authors: Amrita Y Krishnan; Joycelynne Palmer; Auayporn P Nademanee; Robert Chen; Leslie L Popplewell; Ni-Chun Tsai; James F Sanchez; Jennifer Simpson; Ricardo Spielberger; Dave Yamauchi; Stephen J Forman Journal: Biol Blood Marrow Transplant Date: 2017-03-04 Impact factor: 5.742
Authors: Derville O'Shea; Ciarán O'Riain; Manu Gupta; Rachel Waters; Youwen Yang; David Wrench; John Gribben; Andreas Rosenwald; German Ott; Lisa M Rimsza; Harald Holte; Jean-Baptiste Cazier; Nathalie A Johnson; Elias Campo; Wing C Chan; Randy D Gascoyne; Bryan D Young; Louis M Staudt; T Andrew Lister; Jude Fitzgibbon Journal: Blood Date: 2009-01-13 Impact factor: 22.113
Authors: M Loeffler; M Kreuz; A Haake; D Hasenclever; H Trautmann; C Arnold; K Winter; K Koch; W Klapper; R Scholtysik; M Rosolowski; S Hoffmann; O Ammerpohl; M Szczepanowski; D Herrmann; R Küppers; C Pott; R Siebert Journal: Leukemia Date: 2014-07-16 Impact factor: 11.528
Authors: Nina D Wagner-Johnston; Brian K Link; Michelle Byrtek; Keith L Dawson; John Hainsworth; Christopher R Flowers; Jonathan W Friedberg; Nancy L Bartlett Journal: Blood Date: 2015-06-23 Impact factor: 22.113
Authors: Connie L Batlevi; Michael Crump; Charalambos Andreadis; David Rizzieri; Sarit E Assouline; Susan Fox; Richard H C van der Jagt; Amanda Copeland; Diane Potvin; Richard Chao; Anas Younes Journal: Br J Haematol Date: 2017-04-25 Impact factor: 6.998