First-line treatment with R-CHOP or rituximab-bendamustine in patients with follicular lymphoma grade 3A-results of a retrospective analysis

M Pouyiourou^{1

2}, A Meyer³, A Stroux⁴, A Viardot⁵, P La Rosée^{6

7}, G Maschmeyer⁸, D Kämpfe⁹, C Kahl¹⁰, V Vucinic¹¹, A Monecke¹², C Hirt¹³, T Weber¹⁴, J Meissner¹, M Witzens-Harig¹, S Böttcher¹⁵, H Schmalenberg¹⁶, R Marks¹⁷, G Prange-Krex¹⁸, F Kroschinsky¹⁹, E Hauf²⁰, U Keller^{3

20}, K Koch²¹, W Klapper²¹, M Herold²², Christian W Scholz²³; East German Study Group for Hematology and Oncology (OSHO)

Affiliations

¹ Department of Hematology, Oncology and Rheumatology, Universitätsklinikum Heidelberg, Heidelberg, Germany.
² Department of Hematology and Oncology, Vivantes Klinikum Am Urban, Dieffenbachstraße 1, 10967, Berlin, Germany.
³ Department of Hematology, Oncology and Tumor Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴ Institut for Medical Biometrics and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁵ Department of Hematology, Oncology, Palliative Care, Rheumatology and Infectious Diseases, Universitätsklinikum Ulm, Ulm, Germany.
⁶ Department of Oncology, Hematology, Immunology, Infectious Diseases and Palliative Care, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Germany.
⁷ Department of Hematology and Medical Oncology, Universitätsklinikum Jena, Jena, Germany.
⁸ Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany.
⁹ Medical Practice for Hematology and Oncology, Outpatient Chemotherapy and Palliative Care, Lüdenscheid, Germany.
¹⁰ Department of Hematology, Oncology and Palliative Care, Klinikum Magdeburg, Magdeburg, Germany.
¹¹ Department of Hematology and Cell Therapy, Medical Oncology, Hemostaseology, Leipzig, Germany.
¹² Institute of Pathology, Universitätsklinikum Leipzig, Leipzig, Germany.
¹³ Department of Hematology and Oncology, Transplantation Centre and Palliative Care, Universitätsmedizin Greifswald, Greifswald, Germany.
¹⁴ Department of Hematology and Oncology, Universitätsklinikum Halle (Saale), Halle (Saale), Germany.
¹⁵ Department of Hematology, Oncology and Palliative Care, Universitätsmedizin Rostock, Rostock, Germany.
¹⁶ Department of Hematology, Medical Oncology and Palliative Care, Städtisches Klinikum Dresden, Dresden, Germany.
¹⁷ Department of Hematology, Oncology and Stem Cell Transplantation, Universitätsklinikum Freiburg, Freiburg, Germany.
¹⁸ Onkopraxis Dresden, Dresden, Germany.
¹⁹ Department of Hematology and Oncology, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.
²⁰ Department of Hematology and Oncology, Klinikum rechts der Isar der Technischen Universität München, München, Germany.
²¹ Department of Hematopathology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.
²² Oncological Center, Helios Klinikum Erfurt, Erfurt, Germany.
²³ Department of Hematology and Oncology, Vivantes Klinikum Am Urban, Dieffenbachstraße 1, 10967, Berlin, Germany. christianw.scholz@vivantes.de.

PMID: 32734548
DOI: 10.1007/s00277-020-04171-7

Comparative Study

First-line treatment with R-CHOP or rituximab-bendamustine in patients with follicular lymphoma grade 3A-results of a retrospective analysis

M Pouyiourou et al. Ann Hematol. 2020 Dec.

. 2020 Dec;99(12):2821-2829.

doi: 10.1007/s00277-020-04171-7. Epub 2020 Jul 30.

Authors

Affiliations

¹ Department of Hematology, Oncology and Rheumatology, Universitätsklinikum Heidelberg, Heidelberg, Germany.
² Department of Hematology and Oncology, Vivantes Klinikum Am Urban, Dieffenbachstraße 1, 10967, Berlin, Germany.
³ Department of Hematology, Oncology and Tumor Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴ Institut for Medical Biometrics and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁵ Department of Hematology, Oncology, Palliative Care, Rheumatology and Infectious Diseases, Universitätsklinikum Ulm, Ulm, Germany.
⁶ Department of Oncology, Hematology, Immunology, Infectious Diseases and Palliative Care, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Germany.
⁷ Department of Hematology and Medical Oncology, Universitätsklinikum Jena, Jena, Germany.
⁸ Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany.
⁹ Medical Practice for Hematology and Oncology, Outpatient Chemotherapy and Palliative Care, Lüdenscheid, Germany.
¹⁰ Department of Hematology, Oncology and Palliative Care, Klinikum Magdeburg, Magdeburg, Germany.
¹¹ Department of Hematology and Cell Therapy, Medical Oncology, Hemostaseology, Leipzig, Germany.
¹² Institute of Pathology, Universitätsklinikum Leipzig, Leipzig, Germany.
¹³ Department of Hematology and Oncology, Transplantation Centre and Palliative Care, Universitätsmedizin Greifswald, Greifswald, Germany.
¹⁴ Department of Hematology and Oncology, Universitätsklinikum Halle (Saale), Halle (Saale), Germany.
¹⁵ Department of Hematology, Oncology and Palliative Care, Universitätsmedizin Rostock, Rostock, Germany.
¹⁶ Department of Hematology, Medical Oncology and Palliative Care, Städtisches Klinikum Dresden, Dresden, Germany.
¹⁷ Department of Hematology, Oncology and Stem Cell Transplantation, Universitätsklinikum Freiburg, Freiburg, Germany.
¹⁸ Onkopraxis Dresden, Dresden, Germany.
¹⁹ Department of Hematology and Oncology, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.
²⁰ Department of Hematology and Oncology, Klinikum rechts der Isar der Technischen Universität München, München, Germany.
²¹ Department of Hematopathology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.
²² Oncological Center, Helios Klinikum Erfurt, Erfurt, Germany.
²³ Department of Hematology and Oncology, Vivantes Klinikum Am Urban, Dieffenbachstraße 1, 10967, Berlin, Germany. christianw.scholz@vivantes.de.

PMID: 32734548
DOI: 10.1007/s00277-020-04171-7

Abstract

Based on centroblast frequency, follicular lymphoma (FL) is subdivided into grades 1-2, 3A, and 3B. Grade FL3A frequently coexists with FL1-2 (FL1-2-3A). Based on clinical trials, FL1-2 is treated with rituximab (R) or obinutuzumab plus bendamustine (B) or CHOP, while FL3B is treated with R-CHOP. In contrast, there are little data guiding therapy in FL3A. We present a retrospective, multicenter analysis of 95 FL3A or FL1-2-3A and 203 FL1-2 patients treated with R-CHOP or R-B first-line. R-CHOP facilitated a higher response rate (95% versus 76%) and longer overall survival (OS) (3-year OS 89% versus 73%, P = 0.008) in FL3A or FL1-2-3A, whereas the difference in progression-free survival (PFS) did not reach statistical significance. While transformation rates into aggressive lymphoma were similar between both groups, there were more additional malignancies after R-B compared with R-CHOP (6 versus 2 cases). In FL1-2, R-B achieved a higher 3-year PFS (79% versus 47%, P < 0.01), while there was no significant difference regarding OS or transformation. With the limitations of a retrospective analysis, these results suggest a benefit for R-CHOP over R-B in FL3A or FL1-2-3A. Confirmatory data from prospective clinical trials are needed.

Keywords: Bendamustine; CHOP; Follicular lymphoma; Grade 3A; Rituximab.

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References

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First-line treatment with R-CHOP or rituximab-bendamustine in patients with follicular lymphoma grade 3A-results of a retrospective analysis

Affiliations

First-line treatment with R-CHOP or rituximab-bendamustine in patients with follicular lymphoma grade 3A-results of a retrospective analysis

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Research Materials