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- Title
Early Stage Extranodal Follicular Lymphoma: Characteristics, Management, and Outcomes.
- Authors
Andraos, Therese; Ayoub, Zeina; Nastoupil, Loretta; Pinnix, Chelsea; Milgrom, Sarah; Gunther, Jillian; Ng, Sweet Ping; Fowler, Nathan; Neelapu, Sattva; Samaniego, Felipe; Dabaja, Bouthaina
- Abstract
<bold>Introduction: </bold>Extranodal follicular lymphoma (E-FL) is a rare entity that has distinct characteristics and outcomes compared with nodal follicular lymphoma.<bold>Patients and Methods: </bold>This cohort comprised 37 patients with stages I/II E-FL, diagnosed from 2003 to 2013. Outcomes included progression-free survival (PFS), and overall survival (OS). Survival outcomes were calculated using Kaplan-Meier methods.<bold>Results: </bold>Median age was 60 years (range, 37-84 years). Disease was stage I in 29 (78.4%). The Follicular Lymphoma International Prognostic Index score was 0 to 1 in 31 (83.8%), 2 in 2 (5.4%), 3 in 1 (2.7%), and missing in 3 (8.1%). Sites of involvement included the gastrointestinal (GI) tract in 22 (59.5%), and non-GI sites in 15 (40.5%). Initial management consisted of chemotherapy (CHT) alone in 21 (56.8%), radiation therapy (RT) alone in 2 patients (5.4%), RT and rituximab in 1 (2.7%), CHT and RT in 7 (18.9%), and observation in 6 (16.2%). RT was to a median dose of 30.6 Gy (range, 23.4-44.0 Gy). At a median follow-up of 69 months (range, 8-157 months), 5-year PFS and OS were 70.4% and 94.4%, respectively. Although the 5-year PFS of those observed was worse than for those who received therapy (33.3% vs. 77.6%; P = .011), that did not translate into an OS difference. Patients who received RT as part of upfront management had a 100% local control (LC) rate and a trend toward improved 5-year PFS (90% vs. 62.2%; P = .067).<bold>Conclusion: </bold>Early stage E-FL is an indolent disease and is associated with excellent OS. Treatment strategies should be individualized with RT prioritized when LC is a significant goal.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2019, Vol 19, Issue 6, p381
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2019.02.011