Patients with follicular lymphoma (FL) who experience early therapy failure (ETF) within 2 years of frontline immunochemotherapy have poor overall survival (OS). We analyzed the Grupo Español de Linfomas y Trasplantes de Médula Ósea registry to determine whether autologous stem cell transplantation (ASCT) is effective in this high-risk subgroup. Patients with non-transformed FL treated with rituximab were included in the analysis. ETF was defined as relapse/progression within 2 years of starting first-line therapy. We identified two groups: the ETF cohort (n = 52; 38 transplanted in second complete response [CR2] and 14 transplanted in second partial response [PR2]), and the non-ETF cohort (patients receiving ASCT in either CR2 [n = 14] or PR2 [n = 2], but who did not experience ETF following first-line therapy). There were no differences in 5-year progression-free survival (PFS) (49% vs 60%, respectively, P = 0.49) nor in 5-year OS (81% vs 83%, respectively, P = 0.8) between the ETF and non-ETF cohorts. Moreover, in the subgroup of patients who presented an interval from first relapse after primary treatment to ASCT of <1 year, there were neither differences in terms of PFS (49% vs 66%, respectively, P = 0.44) nor in OS (86% vs 85%, respectively, P = 0.9) between both cohorts. Patients in the ETF cohort transplanted in CR showed a plateau in the PFS curves beyond 7 years of follow-up, at 50%. Patients presenting ETF after frontline therapy lack standard therapeutic options. ASCT may be a curative option for ETF in patients who respond to rescue treatments and should be considered an early consolidation option.

DISCLOSURES

The authors declare no conflicts of interest.

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Volume36, Issue5

December 2018

Pages 765-772

Autologous stem cell transplantation may be curative for patients with follicular lymphoma with early therapy failure who reach complete response after rescue treatment

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Autologous stem cell transplantation may be curative for patients with follicular lymphoma with early therapy failure who reach complete response after rescue treatment

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