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Incidence, risk factors and outcome of histological transformation in follicular lymphoma
Author(s) -
Conconi Annarita,
Ponzio Carlotta,
LobettiBodoni Chiara,
Motta Maddalena,
Rancoita Paola M.V.,
Stathis Anastasios,
Moccia Alden A.,
Mazzucchelli Luca,
Bertoni Francesco,
Ghielmini Michele,
Cavalli Franco,
Zucca Emanuele
Publication year - 2012
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2012.09054.x
Subject(s) - medicine , follicular lymphoma , lymphoma , gastroenterology , rituximab , incidence (geometry) , chemotherapy , follicular phase , surgery , physics , optics
Summary Histological transformation ( HT ) into diffuse large B‐cell lymphoma ( DLBCL ) was documented in 37 of the 281 (13%; 95% CI , 9–18) follicular lymphoma ( FL ) patients treated at our institute from 1979 to 2007. HT occurred at a median of 2·75 years from initial FL diagnosis and HT rate was 15% at 10 years and 26% at 14 years, with a plateau from that point onward. Patients with bulky or extranodal disease, or those diagnosed before 1990 had a significantly higher risk of HT . When initial treatment strategies were taken into account, a reduced HT risk was seen in the patients initially managed with a ‘watch and wait’ policy, while the risk appeared significantly increased in the small subset of 18 patients initially managed with rituximab plus chemotherapy ( P = 0·0005). HT was associated with a significantly shorter cause‐specific survival ( P = 0·0002). Predictors of survival after HT were the F ollicular L ymphoma I nternational P rognostic I ndex at diagnosis, as well as age and performance status at the time of HT . Our data confirm the adverse clinical outcome of FL after HT . In keeping with previous isolated reports, our findings suggest that there is a subgroup of patients in whom HT may not occur.