Journal article
Cause of Death in Follicular Lymphoma in the First Decade of the Rituximab Era: A Pooled Analysis of French and US Cohorts
Journal of clinical oncology, Vol.37(2), pp.144-152
01/10/2019
DOI: 10.1200/JCO.18.00400
PMCID: PMC6366812
PMID: 30481079
Abstract
Although the life expectancy of patients with follicular lymphoma (FL) has increased, little is known of their causes of death (CODs) in the rituximab era.
We pooled two cohorts of newly diagnosed patients with FL grade 1-3A. Patients were enrolled between 2001 and 2013 in two French referral institutions (N = 734; median follow-up 89 months) and 2002 and 2012 in the University of Iowa and Mayo Clinic Specialized Program of Research Excellence (SPORE; N = 920; median follow-up 84 months). COD was classified as being a result of lymphoma, other malignancy, treatment related, or all other causes.
Ten-year overall survival was comparable in the French (80%) and US (77%) cohorts. We were able to classify COD in 248 (88%) of 283 decedents. In the overall cohort, lymphoma was the most common COD, with a cumulative incidence of 10.3% at 10 years, followed by treatment-related mortality (3.0%), other malignancy (2.9%), other causes (2.2%), and unknown (3.0%). The 10-year cumulative incidence of death as a result of lymphoma or treatment was higher than death as a result of all other causes for each age group (including patients ≥ 70 years of age at diagnosis [25.4% v 16.6%]) Follicular Lymphoma International Prognostic Index score 3 to 5 (27.4% v 5.2%), but not Follicular Lymphoma International Prognostic Index score 0 to 1 (4.0% v 3.7%); for patients who failed to achieve event-free survival within 24 months from diagnosis (36.1% v 7.0%), but not for patients who achieved event-free survival within 24 months of diagnosis (6.7% v 5.7%); and for patients with a history of transformed FL (45.9% v 4.7%), but not among patients without (8.1% v 6.2%). Overall, 77 of 140 deaths as a result of lymphoma occurred in patients whose FL transformed after diagnosis.
Despite the improvement in overall survival in patients with FL in the rituximab era, their leading COD remains lymphoma, especially after disease transformation. Treatment-related mortality also represents a concern, which supports the need for less-toxic therapies.
Details
- Title: Subtitle
- Cause of Death in Follicular Lymphoma in the First Decade of the Rituximab Era: A Pooled Analysis of French and US Cohorts
- Creators
- Clémentine Sarkozy - Université de LyonMatthew J Maurer - Mayo ClinicBrian K Link - University of IowaHervé Ghesquieres - Université de LyonEmmanuelle Nicolas - Centre Léon BérardCarrie A Thompson - Mayo ClinicAlexandra Traverse-Glehen - Université de LyonAndrew L Feldman - Mayo ClinicCristine Allmer - Mayo ClinicSusan L Slager - Mayo ClinicStephen M Ansell - Mayo ClinicThomas M Habermann - Mayo ClinicEmmanuel Bachy - Université de LyonJames R Cerhan - Mayo ClinicGilles Salles - Université de Lyon
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.37(2), pp.144-152
- DOI
- 10.1200/JCO.18.00400
- PMID
- 30481079
- PMCID
- PMC6366812
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Grant note
- U01 CA195568 / NCI NIH HHS P30 CA086862 / NCI NIH HHS P50 CA097274 / NCI NIH HHS
- Language
- English
- Date published
- 01/10/2019
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9984359871802771
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