Follicular large-cell lymphoma treated with intensive chemotherapy: An analysis of 89 cases included in the LNH87 trial and comparison with the outcome of diffuse large B-cell lymphoma

Wendum, Dominique;Sebban, Catherine;Gaulard, Philippe;Coiffier, Bertrand;Gisselbrecht, Christian;et.al.
(1997) Journal of Clinical Oncology — Vol. 15, n° 4, p. 1654-1663 (1997)

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  • Wendum, Dominique
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  • Sebban, Catherine
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  • Gaulard, Philippe
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  • Coiffier, Bertrand
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  • Ferrant, AugustinUCLouvain
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  • Gisselbrecht, Christian
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Abstract
Purpose: The aims of this study were as follows: (1) to analyze clinical, histopathologic characteristics, treatment outcome, and prognostic factors of patients with follicular large-cell lymphoma (FLCL); and (2) to compare them with those of patients with diffuse large B-cell lymphoma (DLCL) treated in the same therapeutic trial. Patients and Methods: Eighty-wine FLCL patients who were histologically reviewed and who received an intensive chemotherapy regimen according to the LNH 87 protocol were analyzed and compared with 1,096 B-cell DLCL patients included in the same protocol. Results: After intensive induction treatment 59 patients (67%) achieved a complete remission (CR), Estimated 5-year survival was 59%, and estimated 5-year freedom from progression (FFP) was 39%. Prognostic factors associated with shorter FFP were age greater than 60 years (P = .02), advanced clinical stage (P = .01), abnormal lactic dehydrogenase (LDH) revel (P = .02), abnormal beta-2 microglobulin (P = .02), B symptoms (P = .03), bone marrow involvement (P = .04), and high expression of bcl-2 protein (P = .05). When compared with B-cell DLCL patients, FLCL patients were younger (P = .02), had a better Eastern Cooperative Oncology Group (ECOG) status (P = .05), less bulky mass (P = .04), more advanced clinical stages (P < .001), and more bone marrow involvment (P = .02). No significant difference was observed between FLCL and DLCL patients for response to therapy (67% v 67% of: CR), 5-year overall survival (58% v 51%), 5-year disease-free survival (53% v 57%), or FFP survival (39% v 43%). Conclusion: FLCL patients have a favorable response rate and survival when treated with intensive chemotherapy. Their outcome is similar to that of B-cell DLCL patients, and a long-term FFP is observed for a substantial number of patients. Some adverse prognostic Factors (including those of the International Prognostic Index, bone marrow involvement, and beta-2 mitroglobulin) have been identified to define a subset of patients who require other therapeutic approach. (C) 1997 by American Society of Clinical Oncology.
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Wendum, D., Sebban, C., Gaulard, P., Coiffier, B., Tilly, H., Cazals, D., Boehn, A., Casasnovas, R.-O., Bouabdallah, R., Jaubert, J., Ferrant, A., Diebold, J., d eMascarel, A., & Gisselbrecht, C. (1997). Follicular large-cell lymphoma treated with intensive chemotherapy: An analysis of 89 cases included in the LNH87 trial and comparison with the outcome of diffuse large B-cell lymphoma. Journal of Clinical Oncology, 15(4), 1654-1663. https://doi.org/10.1200/JCO.1997.15.4.1654 (Original work published 1997)