International Journal of Hematology

, Volume 100, Issue 3, pp 281–289 | Cite as

Long-term survey of survival time, histological transformation, and secondary malignancies in Japanese patients with advanced-stage follicular lymphoma in the rituximab era: Hokkaido Hematology Study Group

  • Yasuo HirayamaEmail author
  • Kunihiko Ishitani
  • Shuithi Ota
  • Mitsutoshi Kurosawa
  • Takeshi Kondo
  • Rishu Takimoto
  • Akio Mori
  • Hajime Sakai
  • Yoshihiro Torimoto
  • Satoshi Yamamoto
  • Kazuya Sato
  • Hiroshi Iwasaki
  • Kyuhei Kohda
  • Tadao Ishida
  • Yasuhiro Kakinoki
  • Takashi Fukuhara
  • Junji Kato
Original Article


Following the introduction of rituximab, the long-term overall survival (OS) rate of advanced-stage follicular lymphoma (FL) cases was expected to improve after the introduction of rituximab: however, there is a lack of large-scale survey data in Asia due to the relatively low incidence of FL. We conducted a retrospective survey to assess the treatment outcomes in patients with newly diagnosed advanced-stage FL in 29 institutions in Hokkaido from January 2001 to December 2010. The total number of patients was 443 (men 47.6 %, women 52.4 %), with a median age of 55 years (range 20–80 years). Of the cases examined, 42.2 % had stage III and 57.8 % had stage IV disease. Furthermore, 62.5, 19.7, 9.2, 5.2, and 3.4 % had performance statuses of 0, 1, 2, 3, and 4, respectively. The 5-year OS was 91.2 %, and no survival plateau was observed. Seventeen patients experienced secondary malignancies (six hematological diseases and 11 solid cancers; 5-year probability, 4.2 %). Eighteen patients experienced transformation (5-year probability, 4.5 %). The overall survival at 5 years after therapy for transformation was 50 %. Before the introduction of rituximab, the 5- to 10-year OS of advanced-stage FL patients in Japan was reported to be about 30–60 %. Although these data are limited, improvement in OS has been observed in Japan during the rituximab era.


Follicular lymphoma Rituximab Long-term survey Hokkaido Hematology Study Group Overall survival 



The authors thank Kiyohiko Hatake for the helpful advices.


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Copyright information

© The Japanese Society of Hematology 2014

Authors and Affiliations

  • Yasuo Hirayama
    • 1
    Email author
  • Kunihiko Ishitani
    • 3
  • Shuithi Ota
    • 2
    • 4
  • Mitsutoshi Kurosawa
    • 2
    • 5
  • Takeshi Kondo
    • 2
    • 6
  • Rishu Takimoto
    • 2
    • 7
  • Akio Mori
    • 2
    • 8
  • Hajime Sakai
    • 2
    • 9
  • Yoshihiro Torimoto
    • 2
    • 10
  • Satoshi Yamamoto
    • 2
    • 11
  • Kazuya Sato
    • 2
    • 12
  • Hiroshi Iwasaki
    • 2
    • 13
  • Kyuhei Kohda
    • 2
    • 14
  • Tadao Ishida
    • 2
    • 15
  • Yasuhiro Kakinoki
    • 2
    • 16
  • Takashi Fukuhara
    • 2
    • 17
  • Junji Kato
    • 7
  1. 1.Department of Hematology OncologyHigashi Sapporo HospitalSapporoJapan
  2. 2.Hokkaido Hematology Study GroupSapporoJapan
  3. 3.Division of Palliative CareHigashi Sapporo HospitalSapporoJapan
  4. 4.Department of HematologySapporo Hokuyu HospitalSapporoJapan
  5. 5.Department of Hematology, Hokkaido Cancer CenterNational Hospital OrganizationSapporoJapan
  6. 6.Department of HematologyHokkaido University HospitalSapporoJapan
  7. 7.Department of Medical Oncology/HematologySapporo Medical University School of MedicineSapporoJapan
  8. 8.Department of Internal MedicineAiiku HospitalSapporoJapan
  9. 9.Department of HematologyTeine Keijinkai HospitalSapporoJapan
  10. 10.Oncology CenterAsahikawa Medical University HospitalAsahikawaJapan
  11. 11.Department of HematologySapporo City General HospitalSapporoJapan
  12. 12.Department of Hematology/OncologyAsahikawa Kosei HospitalAsahikawaJapan
  13. 13.Department of Hematology/OncologySapporo Kosei HospitalSapporoJapan
  14. 14.Department of Hematology and OncologyAsahikawa Red Cross HospitalAsahikawaJapan
  15. 15.Department of GastroenterologyRheumatology and Clinical Immunology, Sapporo Medical UniversitySapporoJapan
  16. 16.Department of HematologyAsahikawa City General HospitalAsahikawaJapan
  17. 17.Palliative Care CenterSapporo Kosei General HospitalSapporoJapan

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