Response Duration During Treatment of Patients with Follicular Lymphoma

TL;DR

This study examines how long patients with follicular lymphoma remain free of disease progression during different treatment lines, finding that outcomes worsen with each subsequent treatment.

Contribution

The study highlights the 'unmet medical need' in third-line treatment and identifies factors influencing second-line outcomes.

Findings

The progression-free survival for first and second lines of treatment was similar.

Third-line treatment showed significantly worse outcomes, indicating an 'unmet medical need'.

Autologous stem cell transplantation and medium-dose treatment positively impacted second-line outcomes.

Abstract

Background/Objective: It is known that the duration of response to treatment in patients with follicular lymphoma decreases with advancing lines of treatment. Our current study investigated progression-free survival in patients with follicular lymphoma undergoing different lines of treatment, aiming to understand the factors influencing treatment response and outcomes. Methods: We retrospectively analyzed data from follicular lymphoma patients treated at the University of Debrecen between 2009 and 2023. We collected comprehensive data on patient demographics, disease characteristics, treatment regimens, and outcomes. Results: The analysis included 161 patients with follicular lymphoma. The median follow-up for first-line patients was 51 months (range, 3–204), with a median age of 56 years (range, 25–85). The duration of progression-free survival for the first and second lines coincided, while survival in the third line was indeed an ‘unmet medical need’. Factors that influenced the outcome of the first-line treatment of follicular lymphoma patients have been published before by our working group. A univariate analysis of factors that may have influenced the outcome of second-line treatment was performed. A remarkable impact was found in patients undergoing autologous stem cell transplantations and medium-dose treatment. Another important factor was the presence of B-symptoms at the start of second-line treatment. Conclusions: Our study confirmed the interesting coincidence of the first- and second-line duration of response in follicular lymphoma patients, which can be explained with the high number of patients undergoing stem cell transplantation and medium-dose treatment in the second line.

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