Journal article
Disease characteristics, treatment patterns, and outcomes of follicular lymphoma in patients 40 years of age and younger: an analysis from the National Lymphocare Study
Annals of oncology, Vol.26(11), pp.2311-2317
11/2015
DOI: 10.1093/annonc/mdv375
PMCID: PMC5006260
PMID: 26362568
Abstract
Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma, with median age at diagnosis in the seventh decade. FL in young adults (YAs), defined as diagnosis at ≤40 years, is uncommon. No standard approaches exist guiding the treatment of YA FL, and little is known about their disease characteristics and outcomes. To gain further insights into YA FL, we analyzed the National LymphoCare Study (NLCS) to describe characteristics, initial treatments, and outcomes in this population versus patients aged >40 years.
Using the NLCS database, we stratified FL patients by age: 18–40 (YA), 41–60, 61–70, 71–80, and >80 years. Survival probability was estimated using Kaplan–Meier methodology. We examined associations between age and survival using hazard ratios and 95% confidence intervals (CIs) from multivariable Cox models.
Of 2652 eligible FL patients in the NLCS, 164 (6%) were YAs. Of YA patients, 69% had advanced disease, 80% had low-grade histology, and 50% had good-risk disease according to the Follicular Lymphoma International Prognostic Index (FLIPI). Nineteen percent underwent observation, 12% received rituximab monotherapy, and 46% received chemoimmunotherapy [in 59% of these: R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone)]. With a median follow-up of 8 years, overall survival (OS) at 2, 5, and 8 years was 98% (95% CI 93–99), 94% (95% CI 89–97), and 90% (95% CI 83–94), respectively. Median progression-free survival (PFS) was 7.3 years (95% CI 5.6–not reached).
In one of the largest cohorts of YA FL patients treated in the rituximab era, disease characteristics and outcomes were similar to patients aged 41–60 years, with favorable OS and PFS in YAs. Longer-term outcomes and YA-specific survivorship concerns should be considered when defining management. These data may not support the need for more aggressive therapies in YA FL.
Roche/Genentech ML01377 (U2963n).
Details
- Title: Subtitle
- Disease characteristics, treatment patterns, and outcomes of follicular lymphoma in patients 40 years of age and younger: an analysis from the National Lymphocare Study
- Creators
- C Casulo - James P. Wilmot Cancer Center, University of Rochester, RochesterJ.R Cerhan - Department of Health Sciences Research, Mayo Clinic, RochesterB Day - Genentech, Inc., South San FranciscoB.K Link - University of Iowa, Iowa CityK.L Dawson - Genentech, Inc., South San FranciscoX Zhou - RTI Health Solutions, Research Triangle Park, DurhamC.R Flowers - Department of Medicine, Emory University, AtlantaC.M Farber - Carol G. Simon Cancer Center, MorristownJ.D Hainsworth - Sarah Cannon Research Institute, NashvilleA.D Zelenetz - Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, USAJ.W Friedberg - James P. Wilmot Cancer Center, University of Rochester, Rochester
- Resource Type
- Journal article
- Publication Details
- Annals of oncology, Vol.26(11), pp.2311-2317
- Publisher
- Elsevier Ltd
- DOI
- 10.1093/annonc/mdv375
- PMID
- 26362568
- PMCID
- PMC5006260
- ISSN
- 0923-7534
- eISSN
- 1569-8041
- Grant note
- DOI: 10.13039/100004328, name: Genentech; DOI: 10.13039/100007013, name: F. Hoffmann-La Roche; DOI: 10.13039/100004328, name: Genentech; DOI: 10.13039/100004328, name: Genentech; DOI: 10.13039/100007013, name: F. Hoffmann-La Roche; DOI: 10.13039/100004328, name: Genentech
- Language
- English
- Date published
- 11/2015
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9984094544302771
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