PURPOSEPatients with follicular lymphoma (FL) registered in the F2-study and initially managed without treatment were analyzed to describe the presentation and outcome of a watch and wait (W&W) strategy in the rituximab era, to identify parameters for initiating treatment, and to evaluate whether initial W&W could have deleterious effects on treatment efficacy after progression or relapse. PATIENTS AND METHODSBetween 2003 and 2005, 120 patients selected from the 1,093 treatment-naive patients with FL in the F2-study cohort were initially managed expectantly (W&W), and 107 patients were assessed. Most of these patients (80%) had disseminated disease with a low tumor burden according to Groupe d'Etudes des Lymphomes Folliculaires criteria.ResultsAfter a median follow-up of 64 months, treatment was initiated in 54 patients (50%), with a median delay of 55 months for the entire cohort. In a univariate analysis, involvement of more than four nodal areas (hazard ratio [HR], 2.26) and serum albumin less than 3.5 g/dL (HR, 3.51) were predictive of a shorter time to lymphoma treatment initiation. In a multivariate analysis, only involvement of more than four nodal areas remained significant (HR, 2.32). The 4-year freedom from treatment failure (FFTF) rate of W&W patients (79%; 95% CI, 69% to 85%) was not inferior to that of a subgroup of 242 patients from the F2-study cohort with good prognosis characteristics who were initially treated with a rituximab-based regimen (69%; 95% CI, 61% to 76%; P = .103). CONCLUSIONIn the rituximab era, patients with FL in a selected prognostically favorable group can still be managed with W&W. W&W does not seem to have detrimental effects on FFTF and overall survival rates after treatment.

Watchful waiting in low-tumorburden follicular lymphoma in the Rituximab era. Results of a F2 observational / Solal Céligny, P.; Bellei, Monica; Marcheselli, Luigi; Pesce, Emanuela Anna; Pileri, S.; Mclaughlin, P.; Luminari, Stefano; Pro, B.; Montolo, S.; Ferreri, A. J. M.; Deconinck, E.; Milpied, N.; Gordon, L. I.; Federico, Massimo. - In: JOURNAL OF CLINICAL ONCOLOGY. - ISSN 0732-183X. - ELETTRONICO. - 30(31):(2012), pp. 3848-3853. [10.1200/JCO.2010.33.4474]

Watchful waiting in low-tumorburden follicular lymphoma in the Rituximab era. Results of a F2 observational

BELLEI, Monica;MARCHESELLI, Luigi;PESCE, Emanuela Anna;LUMINARI, Stefano;FEDERICO, Massimo
2012

Abstract

PURPOSEPatients with follicular lymphoma (FL) registered in the F2-study and initially managed without treatment were analyzed to describe the presentation and outcome of a watch and wait (W&W) strategy in the rituximab era, to identify parameters for initiating treatment, and to evaluate whether initial W&W could have deleterious effects on treatment efficacy after progression or relapse. PATIENTS AND METHODSBetween 2003 and 2005, 120 patients selected from the 1,093 treatment-naive patients with FL in the F2-study cohort were initially managed expectantly (W&W), and 107 patients were assessed. Most of these patients (80%) had disseminated disease with a low tumor burden according to Groupe d'Etudes des Lymphomes Folliculaires criteria.ResultsAfter a median follow-up of 64 months, treatment was initiated in 54 patients (50%), with a median delay of 55 months for the entire cohort. In a univariate analysis, involvement of more than four nodal areas (hazard ratio [HR], 2.26) and serum albumin less than 3.5 g/dL (HR, 3.51) were predictive of a shorter time to lymphoma treatment initiation. In a multivariate analysis, only involvement of more than four nodal areas remained significant (HR, 2.32). The 4-year freedom from treatment failure (FFTF) rate of W&W patients (79%; 95% CI, 69% to 85%) was not inferior to that of a subgroup of 242 patients from the F2-study cohort with good prognosis characteristics who were initially treated with a rituximab-based regimen (69%; 95% CI, 61% to 76%; P = .103). CONCLUSIONIn the rituximab era, patients with FL in a selected prognostically favorable group can still be managed with W&W. W&W does not seem to have detrimental effects on FFTF and overall survival rates after treatment.
30(31)
3848
3853
Watchful waiting in low-tumorburden follicular lymphoma in the Rituximab era. Results of a F2 observational / Solal Céligny, P.; Bellei, Monica; Marcheselli, Luigi; Pesce, Emanuela Anna; Pileri, S.; Mclaughlin, P.; Luminari, Stefano; Pro, B.; Montolo, S.; Ferreri, A. J. M.; Deconinck, E.; Milpied, N.; Gordon, L. I.; Federico, Massimo. - In: JOURNAL OF CLINICAL ONCOLOGY. - ISSN 0732-183X. - ELETTRONICO. - 30(31):(2012), pp. 3848-3853. [10.1200/JCO.2010.33.4474]
Solal Céligny, P.; Bellei, Monica; Marcheselli, Luigi; Pesce, Emanuela Anna; Pileri, S.; Mclaughlin, P.; Luminari, Stefano; Pro, B.; Montolo, S.; Ferreri, A. J. M.; Deconinck, E.; Milpied, N.; Gordon, L. I.; Federico, Massimo
File in questo prodotto:
File Dimensione Formato  
JCO-2012-Solal-Céligny-JCO.2010.33.4474.pdf

non disponibili

Tipologia: Pre-print dell'autore (bozza pre referaggio)
Dimensione 134.81 kB
Formato Adobe PDF
134.81 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/737466
Citazioni
  • ???jsp.display-item.citation.pmc??? 24
  • Scopus 92
  • ???jsp.display-item.citation.isi??? 84
social impact