In a nutshell
This study evaluated the impact of rituximab (Rituxan) treatment on the risk of lymphoma transformation (development of aggressive lymphoma) in patients with follicular lymphoma (FL). They concluded that this risk can be significantly reduced by the use of first-line (primary treatment) rituximab.
Some background
FL is the second most common type of non-Hodgkin’s lymphoma. One of the main goals of treatment is to avoid transformation to more aggressive subtypes. The most common transformation is to diffuse large B-cell lymphoma (DLBCL). 10 – 70% of patients with FL experience lymphoma transformation.
Previous studies have suggested that rituximab-containing therapy may reduce the risk of lymphoma transformation. The impact of first-line rituximab treatment on this risk and the outcomes of patients after transformation remain under investigation.
Methods & findings
This study included the records of 8116 patients with FL. 68% of patients had grade 1 – 2 FL. 65.7% of patients received first-line rituximab alone or with chemotherapy. Of these, 19% also received maintenance (treatment to help keep cancer from returning) rituximab. Patients were followed-up for an average of 87 months.
Overall, 6.27% of patients experienced lymphoma transformation. The most common included transformation to DLBCL (96%) or grade 3b FL (3%). Survival at 10 years after transformation was 32%.
At follow-up, overall 10-year survival was 68%. The risk of transformation at 10 years was 7.7%. This 10-year risk was 27% lower in patients who received rituximab compared to those who did not Furthermore, compared to patients who received rituximab only as first-line treatment, those who also received maintenance rituximab had a 45% lower risk of transformation.
The bottom line
This study concluded that the risk of transformation in patients with FL can be significantly reduced through the use of first-line rituximab.
The fine print
This study was retrospective, meaning it looked back in time to analyze data of patients who were treated in the past.
What’s next?
If you have been diagnosed with follicular lymphoma, talk to your doctor about rituximab treatment.
Published By :
The Lancet. Haematology
Date :
Aug 01, 2018
