J Shustik1, M Quinn2, J M Connors2, R D Gascoyne3, B Skinnider3, L H Sehn2. 1. Centre for Lymphoid Cancers. Electronic address: jshustik@bccancer.bc.ca. 2. Centre for Lymphoid Cancers. 3. Department of Pathology and Laboratory Medicine of the BC Cancer Agency and the University of British Columbia, Vancouver, Canada.
Abstract
BACKGROUND: The revised World Health Organization (WHO) classification maintains a histological grading system (grades 1-3) for follicular lymphoma (FL) and subdivides grade 3 into 3A (FL3A) and 3B (FL3B) subtypes. Optimal therapy of FL grade 3 and its potential curability with anthracycline-based chemotherapy remain uncertain. PATIENTS AND METHODS: We carried out a retrospective population-based analysis evaluating the clinical characteristics and outcome of FL3A and FL3B as strictly defined by WHO diagnostic criteria. Using the BC Cancer Agency Lymphoid Cancer Database, 161 patients with FL grade 3 were identified and, following detailed pathology review, composed of 139 with FL3A and 22 with FL3B. RESULTS: Patients with FL3B had a higher overall International Prognostic Index (IPI) score than FL3A patients (P = 0.03), though no significant difference in individual IPI risk factor frequencies was noted. More patients with FL3B received front-line anthracycline-containing chemotherapy (82% versus 36%, P ≤ 0.001). With median follow-up of 45 months, no difference in disease-specific survival (P = 0.74) or overall survival (OS) (P = 0.87) was found between FL3A and FL3B and no survival curve plateau was observed. Analysis limited to FL3A patients showed no OS advantage with front-line anthracycline use (P = 0.33). CONCLUSION: Using strict diagnostic criteria, there appears to be no difference in outcome between patients with FL3A and FL3B and no evidence of curability with anthracycline-based therapy.
BACKGROUND: The revised World Health Organization (WHO) classification maintains a histological grading system (grades 1-3) for follicular lymphoma (FL) and subdivides grade 3 into 3A (FL3A) and 3B (FL3B) subtypes. Optimal therapy of FL grade 3 and its potential curability with anthracycline-based chemotherapy remain uncertain. PATIENTS AND METHODS: We carried out a retrospective population-based analysis evaluating the clinical characteristics and outcome of FL3A and FL3B as strictly defined by WHO diagnostic criteria. Using the BC Cancer Agency Lymphoid Cancer Database, 161 patients with FL grade 3 were identified and, following detailed pathology review, composed of 139 with FL3A and 22 with FL3B. RESULTS:Patients with FL3B had a higher overall International Prognostic Index (IPI) score than FL3Apatients (P = 0.03), though no significant difference in individual IPI risk factor frequencies was noted. More patients with FL3B received front-line anthracycline-containing chemotherapy (82% versus 36%, P ≤ 0.001). With median follow-up of 45 months, no difference in disease-specific survival (P = 0.74) or overall survival (OS) (P = 0.87) was found between FL3A and FL3B and no survival curve plateau was observed. Analysis limited to FL3Apatients showed no OS advantage with front-line anthracycline use (P = 0.33). CONCLUSION: Using strict diagnostic criteria, there appears to be no difference in outcome between patients with FL3A and FL3B and no evidence of curability with anthracycline-based therapy.
Authors: Ulrich Jaeger; Marek Trneny; Helen Melzer; Michael Praxmarer; Weerasak Nawarawong; Dina Ben Yehuda; David Goldstein; Bilijana Mihaljevic; Osman Ilhan; Veronika Ballova; Michael Hedenus; Liang-Tsai Hsiao; Wing-Yan Au; Sonja Burgstaller; Gerhard Weidinger; Felix Keil; Christian Dittrich; Cathrin Skrabs; Anton Klingler; Andreas Chott; Michael A Fridrik; Richard Greil Journal: Haematologica Date: 2015-04-24 Impact factor: 9.941
Authors: Jonathan W Friedberg; Michelle Byrtek; Brian K Link; Christopher Flowers; Michael Taylor; John Hainsworth; James R Cerhan; Andrew D Zelenetz; Jamie Hirata; Thomas P Miller Journal: J Clin Oncol Date: 2012-08-20 Impact factor: 44.544
Authors: Sun Ha Boo; Joo Hyun O; Soo Jin Kwon; Ie Ryung Yoo; Sung Hoon Kim; Gyeong Sin Park; Byung Ock Choi; Seung Eun Jung; Seok-Goo Cho Journal: Nucl Med Mol Imaging Date: 2019-06-29
Authors: E Klyuchnikov; U Bacher; K Woo Ahn; J Carreras; N M Kröger; P N Hari; G H Ku; E Ayala; A I Chen; Y-B Chen; J B Cohen; C O Freytes; R P Gale; R T Kamble; M A Kharfan-Dabaja; H M Lazarus; R Martino; A Mussetti; B N Savani; H C Schouten; S Z Usmani; P H Wiernik; B Wirk; S M Smith; A Sureda; M Hamadani Journal: Bone Marrow Transplant Date: 2015-10-05 Impact factor: 5.483
Authors: Z T Ying; H Y Feng; L Mi; Y Q Song; X P Wang; W Zheng; N J Lin; M F Tu; Y Xie; L Y Ping; C Zhang; W P Liu; L J Deng; J Zhu Journal: Zhonghua Xue Ye Xue Za Zhi Date: 2018-09-14