Journal of Clinical Oncology 11(2): 218-224, 1993. is available online.
Journal of Clinical Oncology 11(2): 218-224, 1993. may be available online for subscribers.
Anderson JR, Vose JM, Bierman PJ, et al.
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.
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.
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.
Rheinische Friedrich- Wilhelms- Universität Bonn