Evaluating the effectiveness of stem cell transplant in patients with follicular lymphoma with early treatment failure

This study investigated the effectiveness of autologous stem cell transplantation (autoSCT) for patients with follicular lymphoma who experienced early treatment failure (ETF; relapse or disease progression within 2 years after first-line therapy). This study concluded that autoSCT may be an effective option for these patients.

About 15 – 20% of patients with follicular lymphoma do not respond to first-line chemoimmunotherapy and experience ETF. Patients who experience ETF within two years of initial treatment tend to have poor outcomes. 

AutoSCT may improve survival in these high-risk patients. This treatment involves replacing the patient’s cancer cells with healthy stem cells that come from the patient. This requires high-dose chemotherapy first, to get rid of any remaining cancer cells. Whether autoSCT is an effective option in patients with follicular lymphoma who experience ETF remains under investigation.

This study included the records of 68 patients with follicular lymphoma. 76.5% of these patients experience ETF within 2 years, while 23.5% experienced relapse or disease progression after 2 years from first-line therapy (non-ETF group). All patients underwent autoSCT after treatment failure. Patients were followed-up for an average of 8.1 years.

Overall, five-year progression-free survival (PFS; patients still alive without a return of disease at 5 years) was slightly better in the non-ETF group compared to the ETF group (60% vs. 49%). Five-year overall survival (OS; patients still alive 5 years later) was not significantly different (81% vs. 83%) between patients with ETF and non-ETF.

In the ETF group, 55.9% of patients achieved a complete response (disappearance of all signs of cancer) before the transplant. 20.6% of patients achieved a partial response (tumor shrinkage). After the autoSCT, patients who had a complete response after first-line therapy had a significantly higher PFS (54%) and OS (89%) compared to patients who had a partial response (PFS, 36%; OS, 63%).

This study concluded that autoSCT may be an effective treatment option for patients with follicular lymphoma who experience early treatment failure.

This study was retrospective, meaning it looked back in time to analyze data. The patient population in this study was quite small. A control group of patients who did not have an autoSCT was not included. Larger studies are needed to confirm these results.