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Title: Outcomes in grade 3B follicular lymphoma: an international study led by the Australasian Lymphoma Alliance.
Author: Barraclough, A.
England, J.
Villa, D.
Hapgood, G.
Conn, J.
Doo, N.
Gilbertson, M.
Shaw, B.
Bishton, M.
Saeed, M.
Lee, H.
Fleming, K.
Tam, C.
Douglas, G.
Cheah, C.
Ng, Z.
Rolfe, T.
Mills, A.
Hamad, N.
Cashman, H.
Gleeson, M.
Narayana, M.
Hawkes, E.
Ratnasingam, S.
Abeyakoon, C.
Chong, Geoff
Wai, S.
Ku, M.
Issue Date: 2023
Publication Title: Haematologica
Volume: 108
Issue: 9
Start Page: 2444
End Page: 2453
Abstract: Grade (G) 3B follicular lymphoma (FL) is a rare FL subtype which exists on a histological continuum between 'lowgrade' (Grade 1, 2 and 3A FL) and diffuse large B-cell lymphoma (DLBCL) appearing to share features with each. Clinical characteristics and outcomes are poorly understood due to lack of adequate representation in prospective trials and large-scale analyses. We analyzed 157 G3BFL cases from 18 international centers, and two comparator groups; G3AFL (n=302) and DLBCL (n=548). Composite histology with DLBCL or low-grade FL occurred in approximately half of the G3BFL cases. With a median of 5 years follow-up, the overall survival and progression-free survival of G3BFL patients was better than that of DLBCL patients (P<0.001 and P<0.001, respectively); however, G3BFL patients were younger (P<0.001) with better performance status (P<0.001), less extranodal disease (P<0.001) and more frequently had normal lactate dehydrogenase (P<0.001) at baseline. The overall and progression-free survival of patients with G3BFL and G3AFL were similar (P=0.83 and P=0.80, respectively). After frontline immunochemotherapy, 24% of G3BFL relapsed; relapse rates were 63% in the DLBCL cohort and 19% in the low-grade FL cohort. Eight percent of relapses occurred beyond 5 years. In this G3BFL cohort, the revised International Prognostic Index successfully delineated risk groups, but the Follicular Lymphoma International Prognostic Index did not. We conclude that patients with immunochemotherapy-treated G3BFL have similar survival outcomes to those with G3AFL, yet a favorable baseline profile and distinctly superior prognosis compared to patients with DLBCL.
Internal ID Number: 02332
Health Subject: LYMPHOMA
Type: Journal Article
Appears in Collections:Research Output

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