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• W2951066511 abstract "Introduction: Early events within 24 months (e.g. EFS24, POD24) after initiation of frontline immunochemotherapy (IC) are associated with poor survival in follicular lymphoma (FL). The incidence and outcomes of early transformation compared to early progression of FL remain understudied. We now examine the types of early events and subsequent outcomes by event type in IC treated FL. Methods: Patients prospectively enrolled in the University of Iowa/Mayo Clinic SPORE MER between 2002-2015 with FL grade 1-3A and treated with frontline R-CVP, R-CHOP, and R-bendamustine IC were included. Early event was defined as progression, re-treatment, or death within 24 months of start of IC. Early-events were classified into biopsy proven transformation (tPOD24), biopsy proven FL progression (fPOD24), progression without biopsy (oPOD24), and death without progression or retreatment. Early event frequencies were determined via cumulative incidence. Overall survival (OS) from POD24 was defined as date of progression until death. Validation was performed in patients with grade 1-2 FL treated with R-CVP, R-CHOP, or R-bendamustine enrolled in the Danish LYFO from 2006-2017. Results: 439 patients treated with IC at diagnosis in the MER were evaluated with 28% receiving R-CVP, 44% R-CHOP and 28% B-R based IC. Median age was 59 years (range 23-86), 55% were male, 26% were grade 3A, and FLIPI was high in 35%. Early event rate at 24 months was 6.5% tPOD24, 8.2% fPOD24, 6.3% oPOD24, and 3.3% early deaths, Table. OS after tPOD24 (OS5 = 27%, ref) was inferior to fPOD24 (5-year OS = 54%, HR = 0.36; 95% CI: 0.19-0.70) and oPOD24 (5-year OS = 44%, HR = 0.51; 95% CI: 0.26-1.00), Figure. 630 patients were evaluated in the Danish LYFO cohort with 46% receiving R-CVP, 29% R-CHOP and 25% B-R based IC. Median age was 65 years (range 29-90), 52% were male, and FLIPI was high in 46%. Early event rate was 3.0% tPOD24, 8.0% fPOD24, 2.6% oPOD24, and 5.2% early deaths, Table. OS after tPOD24 (OS5 = 31%, ref) was inferior to fPOD24 (5-year OS = 61%, HR = 0.45; 95% CI: 0.22-0.89), and similar to oPOD24 (5-year OS = 30%, HR = 0.86; 95% CI: 0.39-1.92), Figure. Conclusions: Follicular lymphoma progression is more common than transformation in biopsy-proven early events of IC-treated FL. OS is poor after both tPOD24 and fPOD24 and both represent an unmet clinical need. These histology specific results have implications for clinical trial development and interpretation. Biopsy of early progression in IC-treated FL is necessary for 2ndline management and prognostication. Keywords: follicular lymphoma (FL). Disclosures: Maurer, M: Consultant Advisory Role: Morphosys; Research Funding: Celgene, Nanostring. Jørgensen, J: Consultant Advisory Role: Gilead." @default.
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• W2951066511 date "2019-06-01" @default.
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• W2951066511 title "OUTCOMES AFTER EARLY TRANSFORMATION (tPOD24) VS. EARLY FOLLICULAR LYMPHOMA PROGRESSION (fPOD24) IN FOLLICULAR LYMPHOMA TREATED WITH FRONTLINE IMMUNOCHEMOTHERAPY" @default.
• W2951066511 doi "https://doi.org/10.1002/hon.44_2630" @default.
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