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Response duration and survival shorten after each relapse in patients with follicular lymphoma treated in the rituximab era.
Br J Haematol ; 184(5): 753-759, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30515755
ABSTRACT
Follicular lymphoma (FL) is an indolent disease characterized by long survival but frequent relapses. Before the introduction of rituximab, the clinical course of these patients showed a shorter response duration (RD) after each relapse. In this study, we analysed if this pattern of shortened responses remains in patients treated in the rituximab era. We selected 348 patients newly diagnosed with FL in two institutions between 2001 and 2014 that received chemoimmunotherapy. After a median follow-up of 6·3 years, 10-year progression-free and overall survivals were 53% and 72%, respectively. All patients received first-line, 111 second-line and 41 third-line treatments, with a 5-year RD of 62%, 39% and 24%, respectively (P < 0·0001). Variables predicting longer RD after first-line treatment were normal ß2microglobulin, complete remission achievement and maintenance with rituximab. Patients with longer RD after first-line showed significantly longer RD after second-line therapy. Autologous stem-cell transplantation after second-line therapy did not significantly impact RD. Median survival after first, second and third therapies was not reached, 7·6 and 4·8 years, respectively, whereas relative survival with respect to a sex- and age-matched Spanish population, the decrease in the life expectancy at 10 years was 17%, 45% and 79%, respectively. Thus, RD still shortens after each relapse in patients with FL treated in first line with rituximab combinations.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Linfoma Folicular / Transplante de Células-Tronco / Quimioterapia de Manutenção / Rituximab Aspecto clínico: Predição / Prognóstico / Terapia Limite: Adulto / Idoso / Feminino / Humanos / Masculino / Meia-Idade País/Região como assunto: Europa Idioma: Inglês Revista: Br J Haematol Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Espanha