Progression-free survival after front line, second line and third line in patients with follicular lymphoma treated in clinical practice

Authors

  • Aino Rajamaki Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
  • Marc Sorigue Medical Department, Trialing Health, Barcelona, Spain https://orcid.org/0000-0002-0587-591X
  • Roosa E.I. Prusila Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
  • Milla E.L. Kuusisto Department of Internal Medicine, Länsi-Pohja Central Hospital, Kemi, Finland
  • Hanne Kuitunen Department of Internal Medicine, Länsi-Pohja Central Hospital, Kemi, Finland
  • Esa Jantunen Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; Department of Medicine, Kuopio University Hospital, Kuopio, Finland
  • Santiago Mercadal ICO-Hospital Duran I Reynals, L’Hospitalet, Spain
  • Taina Turpeenniemi-Hujanen Medical Research Center, Oulu University Hospital and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
  • Juan-Manuel Sancho Department of Hematology, ICO-Hospital Germans Trias i Pujol, IJC, UAB, Badalona, Barcelona, Spain
  • Kaisa Sunela Finnish Medicines Agency FIMEA, Barcelona, Spain
  • Outi Kuittinen Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; Medical Research Center, Oulu University Hospital and Translational Medicine Research Unit, University of Oulu, Oulu, Finland; Department of Oncology, Kuopio University Hospital, Kuopio, Finland

DOI:

https://doi.org/10.2340/1651-226X.2024.24377

Keywords:

follicular lymphoma, survival, progression-free survival, treatment

Abstract

Background: The modern-day therapeutic landscape for follicular lymphoma (FL) includes a number of highly effective therapies.

Patients and methods: We set out to determine progression-free survival (PFS) after front line, second line, and third line of therapy on the basis of relevant biological characteristics and therapeutic choices. Patients (n = 743, 51% females, median 60 years old) diagnosed with grade 1–2 FL between 1997 and 2016 in nine institutions were included.

Results: The median PFS1, PFS2, and PFS3 were 8.1 years (95% confidence interval [CI]: 7–9.3 years), 4.2 years (95% CI: 2.8–5.6 years) and 2.2 years (95% CI 1.7–2.8 years). We found longer PFS1 for (1) females, (2) younger age, (3) lower-risk follicular lymphoma international prognostic index (FLIPI), (4) standard intensity (over low intensity) regimens and (5) immunochemotherapy strategies and (6) maintenance rituximab. We found a shorter PFS2 for patients who received front-line immunochemotherapy. Older age at diagnosis correlated with a shorter PFS3. Intensity of front-line chemotherapy, maintenance, or POD24 status did not correlate with PFS2 or PFS3 in this dataset.

Interpretation: With current immunochemotherapy strategies, the natural course of FL is characterized by shorter-lasting remissions after each relapse. It will be interesting to see whether new therapies can alter this pattern.

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2024-05-06

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Rajamaki, A., Sorigue, M., Prusila, R. E., Kuusisto, M. E., Kuitunen, H., Jantunen, E., Mercadal, S., Turpeenniemi-Hujanen, T., Sancho, J.-M., Sunela, K., & Kuittinen, O. (2024). Progression-free survival after front line, second line and third line in patients with follicular lymphoma treated in clinical practice. Acta Oncologica, 63(1), 267–272. https://doi.org/10.2340/1651-226X.2024.24377

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Vol. 63 (2024): Acta Oncologica

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Copyright (c) 2023 Aino Rajamaki, Marc Sorigue, Roosa E.I. Prusila, Milla E.L. Kuusisto, Hanne Kuitunen, Esa Jantunen, Santiago Mercadal, Taina Turpeenniemi-Hujanen, Juan-Manuel Sancho, Kaisa Sunela, Outi Kuittinen

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