Rituximab maintenance improves overall survival in follicular lymphoma: A retrospective nationwide real‐world analysis from Taiwan Cancer Registry Database

Huang, Huai-Hsuan; Wen, Yao-Chun; Chen, Ho‐Min; Hsiao, Fei‐Yuan; Ko, Bor-Sheng

doi:10.1002/cam4.1622

Cited by 6 publications

(12 citation statements)

References 24 publications

(49 reference statements)

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“…Both were analogous to those observed previously in Chinese FL patients and several Western cohorts [ 4 , 8 , 9 ]. We found that rituximab-based induction therapy ( R i ) followed by rituximab maintenance ( R m ) resulted in the best outcomes (both PFS and OS), consistent with the findings from another real-world study in Chinese population [ 10 ]. R i only was superior to Rm only (Fig.…”

supporting

confidence: 90%

Clinical features and outcomes of 1845 patients with follicular lymphoma: a real-world multicenter experience in China

Zha

Fan

et al. 2021

J Hematol Oncol

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Clinical features and outcomes of FL patients in Chinese population are limited, thus promoting us to perform this analysis on a large cohort of 1845 patients with FL enrolled from nine medical centers nationwide in China. In this cohort, the median age of patients at diagnosis was 53 years, which was comparable to that reported previously for Chinese FL patients (49–51 years) but younger than that for Western FL patients (60–65 years). In contrast with Western patients, Chinese FL patients more likely involved extranodal sites but less frequently infiltrated bone marrow. Other clinical characteristics were comparable between two populations. In this study, 91% of patients were managed with chemotherapy, yielding 72% and 46% of overall-response rate and complete remission. After median 55-month follow-up, 5-year progressive-free and overall survival were 61% and 89%, respectively. Both were analogous to those reported in prior Chinese and Western studies. Consistent with published data, addition of rituximab into both induction (Ri) and maintenance (Rm) treatment led to the most favorable outcomes. Interestingly, Ri only had better outcomes than Rm only. Notably, 7% of patients experienced histologic transformation (HT) and correlated with poor survival. Of the transformed FL cases, 3% and 4% of HT events occurred prior to or post-treatment, respectively. Importantly, the latter displayed worse outcomes than the former. Altogether, this study provides real-world information of the largest cohort of FL patients so far in China, which might lay a foundation for clinical investigation of Chinese FL in future.

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supporting

confidence: 90%

Clinical features and outcomes of 1845 patients with follicular lymphoma: a real-world multicenter experience in China

Zha

Fan

et al. 2021

J Hematol Oncol

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“…Maintenance therapy is a known effective strategy in prolonging remission for patients with NHL after induction therapy or stem-cell transplantation. For example, the clinical value of rituximab maintenance in treatment of FL has been demonstrated in several real-world studies in the United States, 14 Taiwan, 15 and Czech Republic. 16 Unfortunately, data on the use of maintenance therapy in low-grade lymphomas were not gathered in the HOLA study, with the exception of Argentina where rituximab maintenance was reported as the most common treatment for DLBCL at first or at second relapse (n = 11 of 74, 14.9% and n = 4 of 18, 22.2%, respectively).…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Patients With B-Cell Non-Hodgkin Lymphoma in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study

Pavlovsky¹,

Cubero

Agreda-Vásquez

et al. 2022

JCO Global Oncology

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PURPOSE Real-world evidence on non-Hodgkin lymphoma (NHL) management in Latin America is currently lacking. The objective of this study was to describe treatment characteristics and outcomes of NHL in Latin America. METHODS A total of 2,967 patients with NHL with aggressive and indolent subtypes, including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), mantle-cell lymphoma (MCL), and mucosa-associated lymphoid tissue (MALT) lymphoma, with incident or prevalent diagnosis between 2006 and 2015, were retrospectively identified using clinical charts registered in the Hemato-Oncology Latin America Observational Registry. Associations between treatment regimen and age at diagnosis with clinical outcomes within each subtype were estimated using Cox proportional hazard regression. RESULTS Most patients with NHL received 1L chemoimmunotherapy, most commonly cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with/without rituximab. Five-year survival rates were higher for MALT lymphoma (90.8%) and FL (87.6%) versus DLBCL (69.0%) and MCL (57.1%), with variations between countries. The median overall survival from first relapse for patients with DLBCL was 6.6 years, with lower risk of death for those diagnosed at age < 65 years (hazard ratio = 0.732; P = .0161). Patients achieved a longer median progression-free survival with 1L rituximab-CHOP (R-CHOP) versus CHOP or rituximab, cyclophosphamide, vincristine, and prednisone (RCVP) (7.7 v 3.0 or 1.8 years, respectively). Use of regimens other than R-CHOP was associated with a higher risk of death/progression for patients with DLBCL (rituximab, ifosfamide, carboplatin, and etoposide/ifosfamide, carboplatin, and etoposide) and FL (CHOP). There was no relationship between treatment prescribed and age at diagnosis with outcomes from first/second relapse in DLBCL and FL. CONCLUSION Differences in treatment outcomes between NHL subtypes were observed, reflecting variations in NHL management and barriers to treatment access in Latin America. These data provide necessary evidence to understand NHL management in this region and highlight the need to improve treatment outcomes for these patients.

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“…Advances in the diagnosis and management of follicular lymphoma (FL) -most notably the introduction of rituximab -have considerably improved the survival of patients with FL over the past decades [1][2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The impact of prior malignancies on the development of second malignancies and survival in follicular lymphoma: A population‐based study

Dinnessen

Visser

Tonino

et al. 2020

eJHaem

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We assessed the impact of a prior malignancy diagnosis (PMD) – as a potential proxy for genetic cancer susceptibility – on the development of a second primary malignancy (SPM) and mortality in follicular lymphoma (FL) patients. From the nationwide Netherlands Cancer Registry, we selected all adult FL patients diagnosed in 1994‐2012 (n = 8028) and PMDs and SPMs relative to FL, with follow‐up until 2017. We constructed two Fine and Gray models – with death as a competing risk – to assess the association between a PMD and SPM incidence. A PMD was associated with an increased incidence of SPMs (subdistribution hazard ratio [SHR], 1.30; 95% confidence interval [CI], 1.03‐1.64) – especially carcinomas of the respiratory tract (SHR, 1.83; 95% CI, 1.10‐3.05) and cutaneous squamous cell carcinomas (SHR, 1.58; 95% CI, 1.01‐2.45) – and a higher risk of mortality in a multivariable model (HR, 1.43; 95% CI, 1.19‐1.71). However, when additionally adjusted for the receipt of systemic therapy and/or radiotherapy before FL diagnosis, only patients who received such therapies had an increased incidence of SPMs (SHR, 1.40; 95% CI, 1.02‐1.93). In conclusion, patients with a PMD had a higher rate of SPMs and mortality than those without a PMD, which might have resulted from therapy‐related carcinogenesis.

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Rituximab maintenance improves overall survival in follicular lymphoma: A retrospective nationwide real‐world analysis from Taiwan Cancer Registry Database

Cited by 6 publications

References 24 publications

Clinical features and outcomes of 1845 patients with follicular lymphoma: a real-world multicenter experience in China

Clinical features and outcomes of 1845 patients with follicular lymphoma: a real-world multicenter experience in China

Clinical Outcomes of Patients With B-Cell Non-Hodgkin Lymphoma in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study

The impact of prior malignancies on the development of second malignancies and survival in follicular lymphoma: A population‐based study

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