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Posted by on Aug 29, 2021 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

The study evaluated the association of interleukin-2 (IL2) receptor (R) levels in the blood (a protein present on immune cells) in selecting a treatment for advanced-stage follicular lymphoma with a low tumor burden (FL-LTB). The study showed that patients with high IL-2R levels had better survival when treated with rituximab (Rituxan) in combination with chemotherapy compared to rituximab alone.

Some background

Follicular lymphoma (Fl) is a type of non-Hodgkin lymphoma (NHL), a cancer of B-cells (immune cells that produce antibodies). Often, patients with FL do not show any symptoms of the disease at diagnosis. This makes it known as a painless NHL. Watchful waiting is recommended to track symptoms. However, this often delays treatment for patients who require immediate treatment.

In patients with newly diagnosed FL, high levels of IL-2R in the blood are associated with poorer outcomes. Rituximab is an immunotherapy commonly recommended to patients with asymptomatic FL-LTB. However, it is not known if rituximab alone or in combination with chemotherapy increases overall survival in advanced-stage FL-LTB and if IL-2R levels can help decide the optimal treatment regimen for these patients. 

Methods & findings

A total of 211 patients with FL who received rituximab were recruited in the study. The patients were then divided into two groups based on the levels of IL-2R at the time of treatment. Patients with IL-2R below1800 IU/ml were included in the low IL-2R group (group 1). Levels above 1800 IU/ml classified patients as high IL-2R (group 2). Patients in each group were further put into 2 different treatment groups. One group received rituximab alone (R group) and the other received rituximab with chemotherapy (R-chemo group). Patients were followed up for an average of 5.3 years.

In group 2, patients treated with R-chemo had a significantly higher survival after 5 years compared to those treated with R alone (94.4% vs 66.7%). In group 1, there was no significant difference in 5-year survival among patients treated with R alone (100%) and R-chemo (98.3%). 

The bottom line

The study concluded that rituximab with chemotherapy improves the outcomes of patients with advanced-stage FL and high IL-2R levels.  

The fine print

There was an unequal distribution of patients between different groups. Also, the study was done on the Japanese population, therefore the results may not be applicable to other populations. 

Published By :

International journal of hematology

Date :

Apr 13, 2021

Original Title :

Pretreatment levels of serum soluble interleukin-2 receptor are useful in selecting the treatment regimen for newly diagnosed advanced-stage follicular lymphoma with low tumor burden.

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