Clinical features and prognosis of follicular large-cell lymphoma: A report from the Nebraska Lymphoma Study Group

James R. Anderson, Julie Marie Vose, Philip Jay Bierman, Dennis D. Weisenburger, Warren G. Sanger, Jene Pierson, Martin Bast, James Olen Armitage

Research output: Contribution to journalArticle

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Abstract

Purpose: Our purpose was to describe the treatment outcome of patients with follicular large-cell lymphoma (FLCL) and to identify prognostic factors that affect the treatment outcome. Patients and Methods: Between 1980 and 1991, 107 newly diagnosed, previously untreated patients with FLCL were prospectively treated using treatment plans of the Nebraska Lymphoma Study Group (NLSG). Most stage I/II patients received two to three cycles of one of four closely related six-drug combination chemotherapy regimens (cyclophosphamide, doxorubicin or mitoxantrone, and procarbazine, plus bleomycin, vincristine, and prednisone or dexamethasone [CAP/BOP I-IV]) plus involved-field radiotherapy; 10 patients received involved-field irradiation only. Stage III/IV patients received six to eight cycles of CAP/BOP. Results: Forty-four percent of patients had stage I/II disease. Stage I/II patients were older and more often female than stage III/IV patients. Cytogenetic studies were available on 35 patients: seven were normal; the most common abnormality was a translocation involving 14q32. Abnormalities of 1p or 1q were also common, often secondary to a 14q32 abnormality. The median follow- up of surviving patients is 2 years. The complete response rates observed were stage I/II, 88%; stage III/IV, 49%. Complete response rates were affected by both age and tumor bulk. Failure-free survival (FFS; time to first occurrence of progression, relapse after response, or death from any cause) at 3 years was estimated to be 61% for stage I/II patients and 34% for stage III/IV patients. Survival at 3 years was estimated to be 76% and 61%, respectively. FFS of stage III/IV patients was poorer for stage IV patients and those with composite lymphomas. Significantly poorer survival was only seen in patients older than 70 years of age. Conclusion: A proportion of stage I/II FLCL patients may obtain long-term disease control with combination chemotherapy plus radiotherapy. Results for patients with stage III/IV FLCL are similar to those seen for other follicular lymphomas.

Original languageEnglish (US)
Pages (from-to)218-224
Number of pages7
JournalJournal of Clinical Oncology
Volume11
Issue number2
DOIs
StatePublished - Jan 1 1993

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Follicular Lymphoma
Lymphoma
Combination Drug Therapy
Survival
Composite Lymphoma
Radiotherapy
Procarbazine
Mitoxantrone
Bleomycin

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Clinical features and prognosis of follicular large-cell lymphoma : A report from the Nebraska Lymphoma Study Group. / Anderson, James R.; Vose, Julie Marie; Bierman, Philip Jay; Weisenburger, Dennis D.; Sanger, Warren G.; Pierson, Jene; Bast, Martin; Armitage, James Olen.

In: Journal of Clinical Oncology, Vol. 11, No. 2, 01.01.1993, p. 218-224.

Research output: Contribution to journalArticle

Anderson, James R. ; Vose, Julie Marie ; Bierman, Philip Jay ; Weisenburger, Dennis D. ; Sanger, Warren G. ; Pierson, Jene ; Bast, Martin ; Armitage, James Olen. / Clinical features and prognosis of follicular large-cell lymphoma : A report from the Nebraska Lymphoma Study Group. In: Journal of Clinical Oncology. 1993 ; Vol. 11, No. 2. pp. 218-224.
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abstract = "Purpose: Our purpose was to describe the treatment outcome of patients with follicular large-cell lymphoma (FLCL) and to identify prognostic factors that affect the treatment outcome. Patients and Methods: Between 1980 and 1991, 107 newly diagnosed, previously untreated patients with FLCL were prospectively treated using treatment plans of the Nebraska Lymphoma Study Group (NLSG). Most stage I/II patients received two to three cycles of one of four closely related six-drug combination chemotherapy regimens (cyclophosphamide, doxorubicin or mitoxantrone, and procarbazine, plus bleomycin, vincristine, and prednisone or dexamethasone [CAP/BOP I-IV]) plus involved-field radiotherapy; 10 patients received involved-field irradiation only. Stage III/IV patients received six to eight cycles of CAP/BOP. Results: Forty-four percent of patients had stage I/II disease. Stage I/II patients were older and more often female than stage III/IV patients. Cytogenetic studies were available on 35 patients: seven were normal; the most common abnormality was a translocation involving 14q32. Abnormalities of 1p or 1q were also common, often secondary to a 14q32 abnormality. The median follow- up of surviving patients is 2 years. The complete response rates observed were stage I/II, 88{\%}; stage III/IV, 49{\%}. Complete response rates were affected by both age and tumor bulk. Failure-free survival (FFS; time to first occurrence of progression, relapse after response, or death from any cause) at 3 years was estimated to be 61{\%} for stage I/II patients and 34{\%} for stage III/IV patients. Survival at 3 years was estimated to be 76{\%} and 61{\%}, respectively. FFS of stage III/IV patients was poorer for stage IV patients and those with composite lymphomas. Significantly poorer survival was only seen in patients older than 70 years of age. Conclusion: A proportion of stage I/II FLCL patients may obtain long-term disease control with combination chemotherapy plus radiotherapy. Results for patients with stage III/IV FLCL are similar to those seen for other follicular lymphomas.",
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AU - Bast, Martin

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