KEY TAKEAWAYS
- The study aimed to examine t-DLBCL outcome post-rituximab era and compare survival with p-DLBCL in the same period.
- Rituximab era improved t-DLBCL outcomes, negating the need for autologous stem cell transplantation in initial watch-and-wait or radiation therapy.
Histological transformation (HT) to diffuse large B-cell lymphoma (DLBCL) from follicular lymphoma (FL) is frequent and historically linked with poor prognosis but has improved with rituximab.
Wenshuai Zheng and the team aimed to evaluate t-DLBCL outcomes post-rituximab era and compare survival with p-DLBCL within that timeframe.
Researchers used the Surveillance, Epidemiology, and End Results (SEER) database to identify individuals diagnosed with primary FL and p-DLBCL from 2000 to 2020. Patients who received a subsequent diagnosis of DLBCL at least 2 months after the FL diagnosis were categorized as having t-DLBCL.
The study identified 50,332 cases of FL and 95,933 cases of p-DLBCL. Over a median follow-up period of 119 months, 1631 patients experienced t-DLBCL. The median time from FL diagnosis to t-DLBCL was approximately 4 years.
At 5 years post-transformation, the survival rate (PTS) was 49.6%, with a median PTS of 56 months. Factors such as older age, advanced stage, and early transformation were associated with poorer PTS outcomes.
Additionally, t-DLBCL patients who received chemotherapy or combined modality therapy as an initial treatment before HT exhibited worse PTS outcomes, although this trend reversed when considering the impact of the initial management strategy at HT.
Comparing overall survival between p-DLBCL and t-DLBCL, similar outcomes were observed for patients who underwent radiation or watch-and-wait as initial therapy before HT.
The study found that the prognosis for t-DLBCL in the rituximab era surpassed that of the historical series preceding the rituximab era. Consequently, they did not advocate for autologous stem cell transplantation in cases of t-DLBCL where patients had initially received watch-and-wait or radiation therapy before hematopoietic transplantation.
No funding was provided.
Source: https://pubmed.ncbi.nlm.nih.gov/38629251/
Zheng W, Liu M, Guan L, et al.(2024) “Outcomes of the transformation of follicular lymphoma to diffuse large B-cell lymphoma in the rituximab era: A population-based study.” Cancer Med. 2024 Apr;13(8):e7120. doi: 10.1002/cam4.7120. PMID: 38629251; PMCID: PMC11022146.
