Disease, treatment, and outcome differences between men and women with follicular lymphoma in the United States

Abstract

We aimed to comprehensively study sex differences in disease and patients’ characteristics, treatment and outcomes in patients with follicular lymphoma (FL) in the United States (USA) utilizing the National LymphoCare Study registry (2004–2014). Among evaluable males (n = 1277) and females (n = 1375) with FL, females less commonly received anthracyclines and were more likely to receive rituximab monotherapy. Overall response rates were comparable between sex groups. With a median follow-up of 8.1 years, male sex emerged as an adverse factor for PFS (HR, 0.84, 95% CI, 0.72–0.97). Lymphoma-related mortality (HR, 0.46; 0.23–0.93) and overall survival (HR, 0.63; 0.41–0.97) favored females aged ≤60 years. There are subtle differences in outcomes between male and female FL patients diagnosed and treated in the contemporary era. These data represent the largest prospective analysis of FL patients in the USA based on sex and can aid design of clinical trials for this disease.

Prognostic value of event‐free survival at 12 and 24 months and long‐term mortality for non‐Hodgkin follicular lymphoma patients: A study report from the Spanish Lymphoma Oncology Group

“…We know that 20% of patients have FL progression within 2 years of the first-line treatment. 21 These results differ from those recently published by Nabhan et al 22 from the LymphoCare study, which found that lymphoma-related mortality (HR, 0.46; 95% CI, 0.23-0.93) and OS (HR, 0.63; 95% CI, 0.41-0.97) favored females who were 60 years old or older. 1 and 2 [see online supporting information]).…”

The prognostic significance of PFS24 in follicular lymphoma following firstline immunotherapy: A combined analysis of 3 CALGB trials

“…In multivariable analysis, male sex, high FLIPI, low albumin, low absolute monocyte count, and interfollicular CD10 staining were all associated with early POD. The association of male sex with early POD and subsequent worse OS suggests a different biology of follicular lymphoma and different pharmacokinetics of rituximab in males compared to females . Hypoalbuminemia and low absolute monocyte count have been correlated with prognosis in other studies in FL .…”

Rituximab maintenance therapy of follicular lymphoma in clinical practice

“…Our results are therefore consistent with the NLCS, which recruited patients from 2004 to 2007: US physicians preferred R‐CHOP (55%), followed by R‐CVP (23%), and R‐fludarabine‐based regimens (16%) as first‐line chemoimmunotherapy. Similar to our findings, females less commonly received anthracyclines . However, these comparisons were not corrected for covariates.…”