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Clinical characteristics and outcomes of relapsed follicular lymphoma after autologous stem cell transplantation in the rituximab era.
Sesques, Pierre; Bourcier, Jessie; Golfier, Camille; Lebras, Laure; Nicolas-Virelizier, Emmanuelle; Hacini, Maya; Perrin, Marie Claire; Voillat, Laurent; Bachy, Emmanuel; Traverse-Glehen, Alexandra; Moreau, Anne; Martin, Laurent; Ramla, Selim; Casasnovas, Olivier; Le Gouill, Steven; Salles, Gilles; Ghesquières, Hervé.
Afiliación
  • Sesques P; Department of Hematology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre-Bénite, France.
  • Bourcier J; Department of Hematology, Nantes University Hospital, CHU of Nantes and CHD Vendée, La Roche-sur-Yon, France.
  • Golfier C; Department of Hematology, Dijon University Hospital, Dijon, France.
  • Lebras L; Department of Hematology, Centre Léon Bérard, Lyon, France.
  • Nicolas-Virelizier E; Department of Hematology, Centre Léon Bérard, Lyon, France.
  • Hacini M; Department of Hematology, Centre Hospitalier Métropole Savoie, Chambéry, France.
  • Perrin MC; Department of Hematology, Centre Hospitalier Fleyriat, Bourg-en-Bresse, France.
  • Voillat L; Department of Hematology, Centre Hospitalier of Chalon-sur-Saône, Chalon-sur-Saône, France.
  • Bachy E; Department of Hematology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre-Bénite, France.
  • Traverse-Glehen A; Department of Pathology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre Bénite, France.
  • Moreau A; Department of Pathology, CHU of Nantes, Nantes, France.
  • Martin L; Department of Pathology, Dijon University Hospital, Dijon, France.
  • Ramla S; Department of Pathology, Dijon University Hospital, Dijon, France.
  • Casasnovas O; Department of Hematology, Dijon University Hospital, Dijon, France.
  • Le Gouill S; Department of Hematology, CHU of Nantes CRCINA INSERM team 10 Nantes, Nantes University NUN Next, Nantes, France.
  • Salles G; Department of Hematology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre-Bénite, France.
  • Ghesquières H; Department of Hematology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre-Bénite, France.
Hematol Oncol ; 38(2): 137-145, 2020 Apr.
Article en En | MEDLINE | ID: mdl-31953963
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a therapeutic option for patients with relapsed follicular lymphoma (FL). The clinical characteristics and outcomes of FL relapse after ASCT in the rituximab era have not yet been fully elucidated. We retrospectively reviewed 414 FL patients treated with ASCT between 2000 and 2014 in four hematology departments. All patients received rituximab as a first-line treatment. We specifically analyzed the clinical characteristics, treatment strategies at relapse, and outcomes of 95 patients (23%) who relapsed after ASCT. The patients (median age, 57 y) received a median of two lines of therapy (range, 2-6) prior to ASCT, with 92% in complete response (CR) or partial response (PR) before ASCT. Histological transformation at relapse after ASCT was observed in 20% of the patients. Treatment at relapse after ASCT consisted of chemotherapy with or without rituximab (n = 45/90, 50%), targeted agents (18%), rituximab monotherapy (14%), or consolidation allogeneic transplantation after induction chemotherapy (12%) and radiotherapy (6%). After relapse, the median progression-free survival (PFS) and overall survival (OS) were 1 year (95% CI, 0.541-1.579) and 5.5 years (95% CI, 1.910-9.099), respectively. In the multivariate analysis, histological transformation (HT) was associated with OS (P = .044; HR 2.439; 95% CI, 1.025-5.806), and a high FLIPI score at relapse was associated with PFS (P = .028; HR 2.469; 95% CI, 1.104-5.521). This retrospective study showed that the period of PFS of patients who relapsed after ASCT is short. A biopsy should be performed for these patients to document the HT. Our results indicate that new treatment strategies will need to be developed for these patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Linfoma Folicular / Trasplante de Células Madre Hematopoyéticas / Rituximab / Recurrencia Local de Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Hematol Oncol Año: 2020 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Linfoma Folicular / Trasplante de Células Madre Hematopoyéticas / Rituximab / Recurrencia Local de Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Hematol Oncol Año: 2020 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido