Skip to main content

Advertisement

SpringerLink
Log in

Long-term outcome of follicular low-grade lymphoma a report of 91 patients

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Summary

We retrospectively analyzed overall survival and survival after progression in 91 patients with low-grade follicular lymphoma (LGFL). Histological subtype was B in 75 patients and C in 16 patients. Twelve patients with localized disease received involved-field radiotherapy; seven patients without bulky disease had no initial therapy. The remaining 72 patients received long-term chlorambucil (9 patients), MOPP or COPBleo (42 patients), or a CHOP-derived regimen (21 patients). Forty-two patients (46%) achieved a complete remission (CR) and 28 patients (31%) achieved a partial remission; 48 of these 70 patients relapsed or progressed. Nineteen of the other 21 patients with stable LGFL progressed. Two other patients failed to respond and rapidly died. Thirty-two of the 67 patients with progressive or relapsed LGFL have died. Median overall survival was 111 months. Age ≥70 years, male sex, B symptoms, histological subtype follicular mixed-cell NHL, tumor size ≥10 cm, number of extranodal sites of disease ≥2, pleural effusion, and Ann Arbor stage III or IV were found to adversely influence overall survival. Failure-free survival < 24 months, failure to achieve a CR after the progression, initial histological subtype follicular mixed cell, initial Ann Arbor stage III or IV, and initial tumoral size ≥10 cm were found to adversely influence survival after progression. Our results suggest that most prognostic factors for overall survival in LGFL are related to histological subtype or tumor burden. Some initial adverse prognostic factors for survival may be also associated with a poor survival after progression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anderson T (1983) Nodular mixed cell lymphoma: is there a potential for a prolonged disease-free survival and cure? In: Bennett JM (ed) Controversies in the management of lymphomas. Martinus Nijhoff Publishers, Boston, pp 225–237

    Google Scholar 

  2. Anderson T, De Vita VT, Simon RM, et al. (1982) Malignant lymphoma. II. Prognostic factors and response to treatment of 473 patients at the National Cancer Institute. Cancer 50: 2708–2721

    Google Scholar 

  3. Armitage JD, Dick FR, Corder MP (1981) Diffuse histiocytic lymphoma after histologic conversion. A poor prognosis variant. Cancer Treat Rep 65: 413–418

    Google Scholar 

  4. Bennett JM, Cain KC, Glick JH, et al. (1986) The significance of bone marrow involvement in non-Hodgkin's lymphoma: the Eastern Cooperative Oncology Group expericnce. J Clin Oncol 4: 1462–1469

    Google Scholar 

  5. Bosly A, Coiffier B, Gisselbrecht C, Tilly H, Auzanneau G, Andrien F, Herbrecht R, Legros M, Devaux Y, Jaubert J, Pignon B, Michaux JL, Humblet Y, Dupriez B, Thyss A, Lederlin P (1992) Bone marrow transplantation prolongs survival after relapse in aggressive-lymphoma patients treated with LNH-84 regimen. J Clin Oncol 10: 1615–1623

    Google Scholar 

  6. Breslow NE, Day NE (1985) The standardized mortality ratio. In: Sen PK (ed) Biostatistics: statistics in biomedical, public health and environmental scicnces. North-Holland/Elsevier Scicnce Publishers BV, New York, pp 55–74

    Google Scholar 

  7. Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M (1971) Report of the committee on Hodgkin's disease staging. Cancer Res 31: 1860–1861

    Google Scholar 

  8. Cheson BD, Wittes RE, Friedman MA (1986) Low-grade non-Hodgkin's lymphomas revisited. Cancer Treat Rep 70: 1051–1054

    Google Scholar 

  9. Coiffier B, Gisselbrecht C, Herbrecht R, Tilly H, Bosly A, Brousse N (1989) LNH-84 regimen: a multicenter study of intensive chemotherapy in 737 patients with aggressive malignant lymphoma. J Clin Oncol 7: 1018–1026

    Google Scholar 

  10. Ersböll J, Schultz HB, Pedersen-Bjergaard J, Nissen NI (1989) Follicular low-grade non-Hodgkin's lymphoma: long-term out-come with or without tumor progression. Eur J Haematol 42: 155–163

    Google Scholar 

  11. Ezdinli EZ, Anderson JR, Melvin F, et al. (1985) Moderate versus aggressive chemotherapy of nudular lymphocytic poorly differentiated lymphoma. J Clin Oncol 3: 769–775

    Google Scholar 

  12. Ezdinli EZ, Harrington DP, Kucuk O, et al. (1987) The effect of intensive intermittent maintenance therapy in advanced low-grade non-Hodgkin's lymphoma. Cancer 60: 156–160

    Google Scholar 

  13. Fouillard L, Gorin NC, Laporte JPh, et al. (1991) Feasibility of autologous bone marrow transplantation for early consolidation of follicular non-Hodgkin's lymphoma. Eur J Haematol 46: 279–284

    Google Scholar 

  14. Freedman AS, Ritz J, Neuberg D, et al. (1991) Autologous bone marrow transplantation in 69 patients with a history of low-grade B-cell non-Hodgkin's lymphoma. Blood 77: 2524–2529

    Google Scholar 

  15. Gallagher CG, Lister TA (1987) Follicular non-Hodgkin's lymphoma. Bailliere's Clin Haematol 1: 141–155

    Google Scholar 

  16. Gallagher CJ, Gregory WM, Jones AE, et al. (1986) Follicular lymphoma: prognostic factors for response and survival. J Clin Oncol 4: 1470–1480

    Google Scholar 

  17. Gospodarowicz MK, Bush RS, Brown TC, et al. (1984) Prognostic factors in nodular lymphomas: a multivariate analysis based on the Princess Margaret Hospital experience. Int J Radiat Oncol Biol Phys 10: 489–497

    Google Scholar 

  18. Gribben JG, Freedman AS, Neuberg D, et al. (1991) Immunologic purging of marrow assessed by PCR before autologous bone marrow transplantation for B-cell lymphoma. N Engl J Med 325: 1525–1533

    Google Scholar 

  19. Gribben JG, Freedman AS, Woo SD, et al. (1991) All advanced-stage non-Hodgkin's lymphomas with a polymerase chain reaction amplifiable breakpoint of bcl-2 have residual cells containing the bcl-2 rearrangement at evaluation and after treatment. Blood 78: 3275–3280

    Google Scholar 

  20. Hochster HS, Kim K, Green MD, et al. (1992) Activity of fludarabine in previously treated non-Hodgkin's low-grade lymphoma: results of an Eastern Cooperative Oncology Group study. J Clin Oncol 10: 28–32

    Google Scholar 

  21. Jones SE (1986) Follicular lymphoma. Do no harm. Cancer Treat Rep 70: 1055–1057

    Google Scholar 

  22. Kaplan ES, Meier P (1958) Nonparametric estimation from incomplete observation. J Am Stat Assoc 53: 452–481

    Google Scholar 

  23. Lennert K (1981) Histopathology of non-Hodgkin's lymphomas (based on the Kiel classification). Springer, Berlin Heidelberg New York

    Google Scholar 

  24. Leonard RCF, Cuzick J, McLennan ICF, et al. (1983) Prognostic factors in non-Hodgkin's lymphoma: the importance of symptomatic stage as an adjunct to the Kiel histopathological classification. Br J Cancer 47: 91–102

    Google Scholar 

  25. Lepage E, Sebban C, Gisselbrecht C, et al. (1990) Treatment of low-grade non-Hodgkin's lymphomas: assessment of doxorubicin in a controlled trial. Hematol Oncol 8: 31–39

    Google Scholar 

  26. Martinsson U, Glimelius B, Hadberg H, Sundstrom C (1988) Prognostic relevance of serum markers in relation to histo-pathology, stage and initial symptoms in advance low-grade non-Hodgkin's lymphomas. Eur J Haematol 40: 289–298

    Google Scholar 

  27. Non-Hodgkin's Lymphoma Pathologic Classification Project (1982) National Cancer Institute-sponsored study of classifications of non-Hodgkin's lymphomas: a summary and description of a working formulation for clinical usage. Cancer 49: 2115–2135

    Google Scholar 

  28. Oviatt DL, Cousar JB, Collins RD, et al. (1984) Malignant lymphomas of follicular center cell origin in human. V. Incidence, clinical features and prognostic implications of transformation of small cleaved cell nodular lymphoma. Cancer 53: 1109–1114

    Google Scholar 

  29. Peto R, Peto J (1972) Asymptotically efficient rank invariant test procedures (with discussion). J R Stat Soc A 135: 185

    Google Scholar 

  30. Portlock CS (1980) Management of the indolent non-Hodgkin's lymphomas. Semin Oncol 7: 292–301

    Google Scholar 

  31. Romaguera JE, McLaughlin P, North L, et al. (1991) Multivariate analysis of prognostic factors in stage-IV follicular low-grade lymphoma: a risk model. J Clin Oncol 9: 762–769

    Google Scholar 

  32. Rosenberg SA (1985) The low-grade non-Hodgkin's lymphomas: challenge and opportunities. J Clin Oncol 3: 299–310

    Google Scholar 

  33. Solal-Celigny P, Lepage E, Brousse N, et al. (1991) Alpha-interferon and chemotherapy in patients with high tumor burden follicular lymphoma. Preliminary results of the “groupe d' etude des lymphomes folliculaires”. Proc Am Soc Clin Oncol (Abstr 955)

  34. Steward WP, Crowther D, McWilliam LJ, et al. (1988) Maintenance chlorambucil after CVP in the management of advanced-stage low-grade histologic type non-Hodgkin's lymphoma. Cancer 61: 441–447

    Google Scholar 

  35. Vita VT De, Serpick AA, Carbone PP (1970) Combination chemotherapy in the treatment of advanced Hodgkin's disease. Ann Intern Med 73: 881

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service des Maladies du Sang, CHU, 1 Place de Verdun, 59037, Lille, France

    P. Morel, B. Dupriez, I. Plantier-Colcher & F. Bauters

  2. Laboratoire d'Anatomie et Cytologie Pathologiques, CHU, Lille, France

    B. Gosselin

  3. Observatoire Régional de la Santé, Lille, France

    C. Declercq

  4. Service d' Hématologie Clinique, CH Valenciennes, France

    J. P. Pollet

Authors
  1. P. Morel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Dupriez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I. Plantier-Colcher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. Gosselin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. Declercq
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. P. Pollet
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. F. Bauters
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Morel, P., Dupriez, B., Plantier-Colcher, I. et al. Long-term outcome of follicular low-grade lymphoma a report of 91 patients. Ann Hematol 66, 303–308 (1993). https://doi.org/10.1007/BF01695972

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01695972

Key words

Search

Navigation