Treatment Patterns and Outcomes in Follicular Lymphoma with POD24: An Analysis from The LEO Consortium

Jonathan R Day; Melissa C Larson; Urshila Durani; Jean L Koff; Yucai Wang; Thomas M Habermann; Izidore S Lossos; Loretta J Nastoupil; Christopher S Strouse; Dai Chihara; Peter Martin; John P Leonard; Jonathon B Cohen; Brad S Kahl; Jia Ruan; Richard Burack; Jonathan W Friedberg; James R Cerhan; Christopher R Flowers; Brian L Link; Matthew J Maurer; Carla Casulo

doi:10.1182/bloodadvances.2024014053

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Treatment Patterns and Outcomes in Follicular Lymphoma with POD24: An Analysis from The LEO Consortium

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Treatment Patterns and Outcomes in Follicular Lymphoma with POD24: An Analysis from The LEO Consortium

Jonathan R Day, Melissa C Larson, Urshila Durani, Jean L Koff, Yucai Wang, Thomas M Habermann, Izidore S Lossos, Loretta J Nastoupil, Christopher S Strouse, Dai Chihara, …

Blood advances, Vol.9(5), pp.1013-1023

03/11/2025

DOI: 10.1182/bloodadvances.2024014053

PMCID: PMC11909426

PMID: 39602301

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Abstract

Progression of disease within 24 months of initial immunochemotherapy (POD24) is a negative prognostic factor for patients with follicular lymphoma (FL). There is no standard treatment following POD24. Assembling an academic-based cohort from the Lymphoma Epidemiology of Outcomes Consortium for Real World Evidence (LEO CREWE), we evaluated patterns of care and outcomes for 256 FL patients with POD24 and retained FL histology. Therapy after POD24 was heterogeneous, with no treatment category accounting for >25% of the total. Among patients initially treated with bendamustine-rituximab, R-CHOP was the predominant second-line choice (42%). Among patients initially treated with R-CHOP, the predominant second-line choice was aggressive salvage therapy (36%). Overall response rate to therapy following POD24 was 66% (95% confidence interval [CI] 59%-72%); complete response rate was 40% (95% CI 33%-46%). Median EFS for therapy after POD24 was 10.4 months (95% CI 8.4-12.8); 5-year OS was 73% (95% CI 68-80%). OS was inferior for patients aged >70 years (HR 2.31 [95% CI 1.27-4.20]) and those with high-risk FLIPI scores at diagnosis (HR 2.10 [95% CI 1.23-3.60]). Cause of death was predominantly lymphoma related. Patients with follicular histology at their POD24 event had a low cumulative incidence of transformation (1.9% at 5 years). Our study is among the largest cohorts describing contemporary patterns of care for patients with POD24, providing a focused dataset useful for interpreting and designing prospective clinical trials in this population.

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Title: Subtitle: Treatment Patterns and Outcomes in Follicular Lymphoma with POD24: An Analysis from The LEO Consortium
Creators: Jonathan R Day - University of Iowa
Melissa C Larson - Mayo Clinic
Urshila Durani - Mayo Clinic
Jean L Koff - Emory University
Yucai Wang - Mayo Clinic
Thomas M Habermann - Mayo Clinic
Izidore S Lossos - University of Miami
Loretta J Nastoupil - The University of Texas MD Anderson Cancer Center
Christopher S Strouse - University of Iowa
Dai Chihara - The University of Texas MD Anderson Cancer Center
Peter Martin - Cornell University
John P Leonard - NewYork–Presbyterian Hospital
Jonathon B Cohen - Emory University
Brad S Kahl - Washington University in St. Louis
Jia Ruan - Cornell University
Richard Burack - University of Rochester
Jonathan W Friedberg - University of Rochester
James R Cerhan - Mayo Clinic
Christopher R Flowers - The University of Texas MD Anderson Cancer Center
Brian L Link - University of Iowa, Iowa City, Iowa, United States
Matthew J Maurer - Mayo Clinic
Carla Casulo - University of Rochester Medical Center
Resource Type: Journal article
Publication Details: Blood advances, Vol.9(5), pp.1013-1023
DOI: 10.1182/bloodadvances.2024014053
PMID: 39602301
PMCID: PMC11909426
NLM abbreviation: Blood Adv
ISSN: 2473-9537
eISSN: 2473-9537
Publisher: ELSEVIER
Grant note: National Cancer Institute: P50CA097274 Lymphoma Research FoundationNational Heart Lung and Blood Institute grant Iowa Stimulating Access to Research in Residency Scholars Program: R38 HL150208
This work was supported by research grants from the National Cancer Institute (Lymphoma Epidemiology of Outcomes U01CA195568 and University of Iowa/Mayo Clinic Specialized Program of Research Excellence P50CA097274) and the Lymphoma Research Foundation (Jaime Peykoff Follicular Lymphoma Initiative Priority Research grant) . J.R.D.'s efforts on the project were supported by National Heart Lung and Blood Institute grant Iowa Stimulating Access to Research in Residency Scholars Program (R38 HL150208) .
Language: English
Electronic publication date: 11/27/2024
Date published: 03/11/2025
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
Record Identifier: 9984751754902771

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