<scp>SIE</scp>, <scp>SIES</scp>, <scp>GITMO</scp> revised guidelines for the management of follicular lymphoma

Zinzani, Pier Luigi; Marchetti, Monia; Billio, Atto; Barosi, Giovanni; Carella, Angelo Michele; Lazzarino, Mario; Martelli, Maurizio; Rambaldi, Alessandro; Rigacci, Luigi; Tarella, Corrado; Vitolo, Umberto; Tura, S

doi:10.1002/ajh.23372

Cited by 31 publications

(27 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…40 The authors felt that asymptomatic patients with stage II-IV, nonbulky disease should be offered watchful waiting as the initial treatment approach. However, they felt that, for patients with localized disease, watchful waiting was not recommended except for patients with a short life expectancy or contraindications to radiotherapy.…”

Section: Recommendations From Treatment Guidelinesmentioning

confidence: 99%

Is watch and wait still acceptable for patients with low-grade follicular lymphoma?

Armitage

Longo

2016

Blood

View full text Add to dashboard Cite

Follicular lymphoma (FL) represents more than 20% of all non-Hodgkin lymphomas worldwide and approximately 30% of the non-Hodgkin lymphomas diagnosed in the United States. Although occasionally localized at the time of diagnosis, most patients have disseminated disease. However, patients are frequently asymptomatic, and this, in combination with a long median survival, led to the initial studies of observing asymptomatic patients without initial therapy, ie, “watch and wait.” Since the initial report of watch and wait as a treatment strategy for patients with low-grade FL, our understanding of the biology of the disease has advanced; multiple active new agents have been introduced into practice, and the survival of patients with low-grade FL has improved. Given these changes, is watch and wait still an acceptable treatment recommendation for a newly diagnosed patient with low-grade FL?

show abstract

Section: Recommendations From Treatment Guidelinesmentioning

confidence: 99%

Is watch and wait still acceptable for patients with low-grade follicular lymphoma?

Armitage

Longo

2016

Blood

View full text Add to dashboard Cite

show abstract

“…The Italian Society of Haematology, the Italian Society of Experimental Haematology, and the Italian Bone Marrow Transplantation Group have published guidelines for the management of both follicular and non-follicular i-NHL patients [4,5], suggesting WW as a valuable initial option especially in asymptomatic patients with FL stage II-IV and low tumour burden [4]. Similar to FL, asymptomatic patients with splenic MZL are commonly monitored without any treatment since WW does not compromise survival [6]; nevertheless, patients should be treated if they are symptomatic or have bulky disease or cytopenia [7].…”

Section: Introductionmentioning

confidence: 99%

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

et al. 2017

Self Cite

View full text Add to dashboard Cite

The indolent non-Hodgkin lymphomas (i-NHLs) are characterised by 'indolent' clinical behaviour with slow growth and prolonged natural history. The watchful waiting (WW) strategy is a frequently employed treatment option in these patients. This implies a strict monitoring by imaging examinations, including 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) and CT. A major concern is radiation exposure due to regularly monitoring by conventional imaging procedures. Several studies have demonstrated the reliability of whole-body magnetic resonance imaging (WB-MRI) for lymphoma staging. WB-MRI could be useful for active surveillance in iNHLs providing the suspect of disease progression that can be then confirmed by additional diagnostic procedures, including 18F-FDG-PET/CT. The directive 2013/59 by the European Union claims that if a radiation-free imaging technique allows obtaining the same diagnostic results, it should be invariably used.In this setting, WB-MRI may be considered a reasonable option in i-NHLs under WW, replacing imaging modalities that cause exposure to ionising radiations. This will help to reduce the cancer risk in i-NHL patients for whom chemo-/radiotherapy remain the usual treatment options following the usually long WW phase. The scientific community should raise the awareness of the risk of ionising radiations in i-NHLs and the emphasise the need for establishing the proper place of WB-MRI in lymphoma imaging. Key Points• Watchful waiting is a reasonable option in patients with indolent non-Hodgkin lymphomas.• Imaging is crucial to monitor patients with indolent nonHodgkin lymphomas.• CT and 18 F-FDG-PET/CT are commonly used, implying a substantial radiation exposure.• WB-MRI is highly reliable in lymphoma staging.• WB-MRI may be considered to monitor indolent nonHodgkin lymphomas under watchful waiting.

show abstract

“…It is still unclear whether subsequent intervention to eradicate residual disease in patients with a positive result on endtherapy PET would achieve OS gain compared with watchful observation until progression occurs, given that follicular lymphoma has an indolent nature and tends to relapse frequently during its natural history (33).…”

Section: Discussionmentioning

confidence: 99%

“…Despite these findings, no consensus guidelines have adopted PET for postchemotherapy response assessment in follicular lymphoma, and further therapeutic decisions solely based on end-therapy PET results are not accepted as standard of care because end-therapy PET has not been shown to be more predictive of OS than CT, in a disease with an indolent relapsing and remitting course (7,11,33). It is still unclear whether subsequent intervention to eradicate residual disease in patients with a positive result on endtherapy PET would achieve OS gain compared with watchful observation until progression occurs, given that follicular lymphoma has an indolent nature and tends to relapse frequently during its natural history (33).…”

Section: Discussionmentioning

confidence: 99%

End-Therapy Positron Emission Tomography for Treatment Response Assessment in Follicular Lymphoma: A Systematic Review and Meta-analysis

Pyo

Kim

Jacene

et al. 2013

Clinical Cancer Research

View full text Add to dashboard Cite

Purpose: Use of 2[18 F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in postchemotherapy response assessment in follicular lymphoma is still a controversial issue. Here, we conducted the first systematic review and meta-analysis to determine the predictive value of FDG-PET in predicting outcome after chemotherapy of follicular lymphoma. Experimental Design: Comprehensive literature search in Ovid-MEDLINE and EMBASE databases was performed to identify studies which evaluate predictive value of end-therapy PET and/or computed tomography (CT) in patients with follicular lymphoma. To quantitatively compare the predictive value of PET and CT, pooled hazard ratios (HRs) comparing progression-free survival (PFS) between patients with positive and negative results were adopted as the primary indicators for meta-analysis. To explore the efficiency in determining complete remission (CR), pooled CR rates of PET-and CT-based response criteria were calculated. Pooling of these parameters was based on the random-effects model.Results: Review of 285 candidate articles identified eight eligible articles with a total of 577 patients for qualitative review and meta-analysis. The pooled HRs of end-therapy PET and CT were 5.1 [95% confidence interval (CI), 3.7-7.2] and 2.6 (95% CI, 1.2-5.8), respectively, which implies that PET is more predictive of PFS after chemotherapy than CT. The pooled CR rates of PET-and CT-based response criteria were 75% (95% CI, 70-79%) and 63% (95% CI, 53-73%), respectively, which implies that PET is more efficient in distinguishing CR (without residual disease) from other states with residual disease. In addition, qualitative systematic review indicates the same findings.Conclusions: Consistent evidence favoring PET-based treatment assessment should be considered in the management of patients with follicular lymphoma.

show abstract

SIE, SIES, GITMO revised guidelines for the management of follicular lymphoma

Cited by 31 publications

References 69 publications

Is watch and wait still acceptable for patients with low-grade follicular lymphoma?

Is watch and wait still acceptable for patients with low-grade follicular lymphoma?

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

End-Therapy Positron Emission Tomography for Treatment Response Assessment in Follicular Lymphoma: A Systematic Review and Meta-analysis

Contact Info

Product

Resources

About