The pretransplant Follicular Lymphoma International Prognostic Index is associated with survival of follicular lymphoma patients undergoing autologous hematopoietic stem cell transplantation

Keeney, Grant E.; Gooley, Ted; Pham, Rosalyn N.; Press, Oliver W.; Pagel, John M.; Petersdorf, Stephen H.; Maloney, David G.; Bensinger, William I.; Holmberg, Leona; Gopal, Ajay K.

doi:10.1080/10428190701583983

Cited by 16 publications

(7 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We speculate that the development of R-refractoriness reflects tumor biology evolution that confers more resistant disease which can only be partially overcome with high-dose therapy, making R-sensitivity an important pre-ASCT prognostic marker. Another pre-ASCT prognostic marker – high FLIPI score has limited use because it defines only a small proportion patients (15 to 36% in published studies)[13–15], and accounted for only 20% in our study, with heterogeneous outcomes seen in the remaining 80% of our patients.…”

Section: Resultsmentioning

confidence: 92%

Autologous transplant for relapsed follicular lymphoma: impact of pre-transplant rituximab sensitivity

Phipps

Gopal

Storer

et al. 2014

Leukemia & Lymphoma

Self Cite

View full text Add to dashboard Cite

Rituximab-refractory follicular lymphoma (FL) patients have limited options. Before the rituximab era, autologous stem cell transplantation (ASCT) was shown to improve outcomes in chemotherapy-sensitive, relapsed FL, but the impact of rituximab-sensitivity on these results is unknown. We analyzed 194 consecutive relapsed FL patients who underwent ASCT at out center and categorized them as rituximab-sensitive (RS, n=35), rituximab-refractory (RR, n=65), or no rituximab (NoR, n=94) if transplanted before rituximab was used. Progression-free survival at 3 years was 85% in RS and 35% in RR patients (P = .0004). Only rituximab-sensitivity was significant on multivariate analysis with improved OS (HR 0.24, P = .01) and PFS (HR 0.35, P = .006) in RS patients and increased relapse in RR patients (HR 2.11, P = .01). Pre-transplant rituximab-sensitivity is a strong independent predictor of post-transplant outcomes in relapsed FL, though one-third of RR patients achieved a PFS of over 3 years with ASCT.

show abstract

Section: Resultsmentioning

confidence: 92%

Autologous transplant for relapsed follicular lymphoma: impact of pre-transplant rituximab sensitivity

Phipps

Gopal

Storer

et al. 2014

Leukemia & Lymphoma

Self Cite

View full text Add to dashboard Cite

show abstract

“…Data from our center indicate that chemosensitivity defined as a CT-assessed partial response or CR prior to transplant, as well as pretransplant Follicular Lymphoma International Prognostic Index score, is independently associated with survival. 19 Patients entering transplant in remission had twofold greater survival compared with those who did not. We also retrospectively evaluated the impact of rituximab sensitivity and noted that this was the most important predictor of PFS (HR for progression or death, 0.35; P 5 .006) and OS (HR for death, 0.24; P 5 .01), when evaluated in the context of other available factors.…”

Section: Initial Consolidationmentioning

confidence: 99%

Where does transplant fit in the age of targeted therapies?

Chow

Gopal

2019

Hematology

Self Cite

View full text Add to dashboard Cite

The role of hematopoietic cell transplantation (HCT) for indolent lymphoma has evolved over the last 5 years with the availability of novel low-toxicity therapies and a better understanding of the prognosis of these entities. However, despite numerous treatment options for patients with follicular lymphoma, none are thought to be curative, and many require ongoing therapy with chronic toxicity. Historical trials indicate that autologous HCT as initial consolidation leads to improved progression-free survival, but not overall survival (OS) and, thus, is not typically recommended. However, autologous HCT for chemosensitive relapse can be carried out with ∼1% early mortality risk, affording disease control lasting a median of 3 to 5 years and the potential to improve OS. These results may compare favorably in efficacy, toxicity, and cost vs multiple sequential novel therapies with shorter durations of benefit. Recent data indicate that autologous HCT in follicular lymphoma patients with early initial progression will result in more than one third being alive and without relapse at 5 years, leading to improved OS when used within a year of the first recurrence. Unlike other available therapies, allogeneic HCT has the potential to cure up to one half of those transplanted with indolent B-cell non-Hodgkin lymphoma, although the risks need to be recognized and appropriate patient and donor selection is critical to ensure the best outcomes. HCT continues to remain a viable option in the current era of multiple targeted agents.

show abstract

“…Both were defined retrospectively, before the introduction of rituximab therapy, and neither takes into account any of the putative biologic prognostic markers described previously in this review. However, the FLIPI appears to identify a larger proportion of high‐risk patients than the ILI index, 52 and it is useful in most clinical settings, including early‐stage, 53 first progression, 54 histologic transformation, 55 and autologous stem cell transplantation (SCT)‐ 56 and rituximab‐treated 57 FL patients.…”

Section: Clinical Presentations and Prognostic Factorsmentioning

confidence: 99%

Aiming at a Curative Strategy for Follicular Lymphoma

Bendandi

2008

CA: A Cancer Journal for Clinicians

View full text Add to dashboard Cite

Follicular lymphoma is often managed as an incurable disease. However, a substantial and growing fraction of patients are achieving long-term disease-free survival from aggressive treatment approaches. The application of novel therapeutic tools, including monoclonal antibodies, radioimmunotherapy, and vaccines, as well as new and more active chemotherapeutic agents, is producing complete responses in the majority of treated patients, with a 2-fold increase in disease-and progression-free survival in randomized trials. For some of these treatment approaches, follow up has not yet been long enough to determine a median response duration, but it certainly exceeds the "2 to 3 years" that is routinely stated as dogma to patients with this illness. Furthermore, some patients remain in complete remission beyond a decade from their initial treatment, implying that the assumption of inevitable relapse also must be challenged. One clear fact is that no patients will ever be cured by adopting a palliative treatment approach. The assumption that patients with follicular lymphoma are incurable is certain to be a selffulfilling prophecy. Here the author summarizes the large and growing body of knowledge that suggests an expectant approach to management is not appropriate for all patients. (CA Cancer J Clin 2008;58:305-317.)

show abstract

The pretransplant Follicular Lymphoma International Prognostic Index is associated with survival of follicular lymphoma patients undergoing autologous hematopoietic stem cell transplantation

Cited by 16 publications

References 34 publications

Autologous transplant for relapsed follicular lymphoma: impact of pre-transplant rituximab sensitivity

Autologous transplant for relapsed follicular lymphoma: impact of pre-transplant rituximab sensitivity

Where does transplant fit in the age of targeted therapies?

Aiming at a Curative Strategy for Follicular Lymphoma

Contact Info

Product

Resources

About