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Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma

Between 1998 and 2009, a total of 295 patients (median age 58, 53% females) with newly diagnosed early-stage follicular lymphoma (FL) were managed at Memorial Sloan Kettering Cancer Center. Approximately half of patients (137, 46%) underwent initial observation and half (158, 54%) immediate treatmen...

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Autores principales: Sha, Fushen, Okwali, Michelle, Alperovich, Anna, Caron, Philip C., Falchi, Lorenzo, Hamilton, Audrey, Hamlin, Paul A., Horwitz, Steven M., Joffe, Erel, Khan, Niloufer, Kumar, Anita, Matasar, Matthew J., Moskowitz, Alison J., Noy, Ariela, Owens, Colette, Palomba, Lia M., Rodriguez-Rivera, Ildefonso, Straus, David, von Keudell, Gottfried, Zelenetz, Andrew D., Yahalom, Joachim, Dogan, Ahmet, Schöder, Heiko, Seshan, Venkatraman E., Salles, Gilles, Younes, Anas, Batlevi, Connie L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831497/
https://www.ncbi.nlm.nih.gov/pubmed/35145059
http://dx.doi.org/10.1038/s41408-022-00620-w
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author Sha, Fushen
Okwali, Michelle
Alperovich, Anna
Caron, Philip C.
Falchi, Lorenzo
Hamilton, Audrey
Hamlin, Paul A.
Horwitz, Steven M.
Joffe, Erel
Khan, Niloufer
Kumar, Anita
Matasar, Matthew J.
Moskowitz, Alison J.
Noy, Ariela
Owens, Colette
Palomba, Lia M.
Rodriguez-Rivera, Ildefonso
Straus, David
von Keudell, Gottfried
Zelenetz, Andrew D.
Yahalom, Joachim
Dogan, Ahmet
Schöder, Heiko
Seshan, Venkatraman E.
Salles, Gilles
Younes, Anas
Batlevi, Connie L.
author_facet Sha, Fushen
Okwali, Michelle
Alperovich, Anna
Caron, Philip C.
Falchi, Lorenzo
Hamilton, Audrey
Hamlin, Paul A.
Horwitz, Steven M.
Joffe, Erel
Khan, Niloufer
Kumar, Anita
Matasar, Matthew J.
Moskowitz, Alison J.
Noy, Ariela
Owens, Colette
Palomba, Lia M.
Rodriguez-Rivera, Ildefonso
Straus, David
von Keudell, Gottfried
Zelenetz, Andrew D.
Yahalom, Joachim
Dogan, Ahmet
Schöder, Heiko
Seshan, Venkatraman E.
Salles, Gilles
Younes, Anas
Batlevi, Connie L.
author_sort Sha, Fushen
collection PubMed
description Between 1998 and 2009, a total of 295 patients (median age 58, 53% females) with newly diagnosed early-stage follicular lymphoma (FL) were managed at Memorial Sloan Kettering Cancer Center. Approximately half of patients (137, 46%) underwent initial observation and half (158, 54%) immediate treatment: radiation alone (n = 108), systemic treatment alone (n = 29), or combined modality treatment (n = 21). Median follow-up was 8.4 years (range 0.3–17.2), and 10-year overall survival (OS) was 87.2%. OS was similar between initially-observed and immediately-treated patients (hazard ratio [HR]: 1.25, 95% CI: 0.67–2.36, p = 0.49). For patients receiving radiation alone, 5-year OS was 98.0%. Patients selected for systemic therapy alone had high-risk baseline features and had shorter OS than patients treated with radiation alone (HR 3.38, 95% CI 1.29–8.86, p = 0.01). Combined modality treatment did not yield superior survival compared with radiation alone (P > 0.05) but was associated with better progression-free survival (HR 0.36, 95% CI 0.14–0.90, p = 0.03). The rate of transformation increased steadily over time and was 4.2% at 5 years and 10.8% at 10 years. This modern-era analysis rationalized the role of initial observation in patients with early-stage FL although patients receiving radiation therapy also demonstrate excellent outcome.
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spelling pubmed-88314972022-02-24 Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma Sha, Fushen Okwali, Michelle Alperovich, Anna Caron, Philip C. Falchi, Lorenzo Hamilton, Audrey Hamlin, Paul A. Horwitz, Steven M. Joffe, Erel Khan, Niloufer Kumar, Anita Matasar, Matthew J. Moskowitz, Alison J. Noy, Ariela Owens, Colette Palomba, Lia M. Rodriguez-Rivera, Ildefonso Straus, David von Keudell, Gottfried Zelenetz, Andrew D. Yahalom, Joachim Dogan, Ahmet Schöder, Heiko Seshan, Venkatraman E. Salles, Gilles Younes, Anas Batlevi, Connie L. Blood Cancer J Article Between 1998 and 2009, a total of 295 patients (median age 58, 53% females) with newly diagnosed early-stage follicular lymphoma (FL) were managed at Memorial Sloan Kettering Cancer Center. Approximately half of patients (137, 46%) underwent initial observation and half (158, 54%) immediate treatment: radiation alone (n = 108), systemic treatment alone (n = 29), or combined modality treatment (n = 21). Median follow-up was 8.4 years (range 0.3–17.2), and 10-year overall survival (OS) was 87.2%. OS was similar between initially-observed and immediately-treated patients (hazard ratio [HR]: 1.25, 95% CI: 0.67–2.36, p = 0.49). For patients receiving radiation alone, 5-year OS was 98.0%. Patients selected for systemic therapy alone had high-risk baseline features and had shorter OS than patients treated with radiation alone (HR 3.38, 95% CI 1.29–8.86, p = 0.01). Combined modality treatment did not yield superior survival compared with radiation alone (P > 0.05) but was associated with better progression-free survival (HR 0.36, 95% CI 0.14–0.90, p = 0.03). The rate of transformation increased steadily over time and was 4.2% at 5 years and 10.8% at 10 years. This modern-era analysis rationalized the role of initial observation in patients with early-stage FL although patients receiving radiation therapy also demonstrate excellent outcome. Nature Publishing Group UK 2022-02-10 /pmc/articles/PMC8831497/ /pubmed/35145059 http://dx.doi.org/10.1038/s41408-022-00620-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Sha, Fushen
Okwali, Michelle
Alperovich, Anna
Caron, Philip C.
Falchi, Lorenzo
Hamilton, Audrey
Hamlin, Paul A.
Horwitz, Steven M.
Joffe, Erel
Khan, Niloufer
Kumar, Anita
Matasar, Matthew J.
Moskowitz, Alison J.
Noy, Ariela
Owens, Colette
Palomba, Lia M.
Rodriguez-Rivera, Ildefonso
Straus, David
von Keudell, Gottfried
Zelenetz, Andrew D.
Yahalom, Joachim
Dogan, Ahmet
Schöder, Heiko
Seshan, Venkatraman E.
Salles, Gilles
Younes, Anas
Batlevi, Connie L.
Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma
title Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma
title_full Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma
title_fullStr Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma
title_full_unstemmed Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma
title_short Clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma
title_sort clinical outcomes with use of radiation therapy and risk of transformation in early-stage follicular lymphoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831497/
https://www.ncbi.nlm.nih.gov/pubmed/35145059
http://dx.doi.org/10.1038/s41408-022-00620-w
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