A multi-center retrospective analysis of patients with relapsed/refractory follicular lymphoma after third-line chemothe
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ORIGINAL ARTICLE
A multi-center retrospective analysis of patients with relapsed/refractory follicular lymphoma after third-line chemotherapy Shigeo Fuji 1 & Yuma Tada 1 & Kenji Nozaki 2 & Hideaki Saito 2 & Takayuki Ozawa 2 & Toru Kida 3 & Satoru Kosugi 3 & Hiroyuki Sugahara 4 & Hirokazu Ikeda 5 & Koji Hashimoto 6 & Takahiro Karasuno 7 & Shuji Ueda 8 & Jun Ishikawa 1 & Hirohiko Shibayama 2 Received: 10 March 2020 / Accepted: 3 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The overall outcome of patients with advanced-stage follicular lymphoma (FL) has improved significantly. However, some patients still develop multiple relapsed/refractory FL (RRFL). To address the still-limited data on this population, we performed this multi-center retrospective study. We analyzed 41 patients who received third-line treatment for RRFL at 8 institutes. The median age at diagnosis was 59 years (range, 38–70). The median progression-free survival (PFS) and probability of PFS at 2 years were 1.61 years and 39.4%, respectively, after third-line chemotherapy, and 0.45 years and 19.0%, respectively, after fourth-line chemotherapy. Objective response (OR) after third-line chemotherapy was achieved in 24 patients (53.7%). Bendamustine (Ben)-based regimens were associated with a significantly higher OR rate than other regimens (77.8% vs. 40.0%, respectively, P = 0.025). The median overall survival (OS) and probability of OS at 2 years were 4.71 years and 65.9%, respectively, after third-line chemotherapy, and 1.01 year and 45.1%, respectively, after fourth-line chemotherapy. In conclusion, this study had a small sample size and retrospective design, but it was able to demonstrate poor response rate and duration in patients with multiple RRFL, particularly after fourth-line chemotherapy. The optimal treatment strategy in this population should be clarified, including possibly hematopoietic stem cell transplantation. Keywords Follicular lymphoma . Relapse . Hematopoietic stem cell transplantation . Bendamustine
Introduction * Shigeo Fuji [email protected] 1
Department of Hematology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka City, Osaka 5418567, Japan
2
Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
3
Department of Hematology, Toyonaka Municipal Hospital, Osaka, Japan
4
Department of Hematology, Sumitomo Hospital, Osaka, Japan
5
Department of Hematology, National Hospital Organization Osaka National Hospital, Osaka, Japan
6
Department of Hematology, Kansai Rosai Hospital, Hyogo, Japan
7
Department of Hematology, Rinku General Medical Center, Osaka, Japan
8
Department of Hematology, Hyogo Prefectural Nishinomiya Hospital, Hyogo, Japan
The overall clinical outcome of patients with advanced-stage follicular lymphoma (FL) has significantly improved over the past few decades [1]. However, some patients still experience multiple relapses, short remission durations, and histological transformation (HT) [2]. Previou
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