LONG-TERM OUTCOME OF FOLLICULAR LOW-GRADE LYMPHOMA - A REPORT OF 91 PATIENTS

We retrospectively analyzed overall survival and survival after progre ssion in 91 patients with low-grade follicular lymphoma (LGFL). Histol ogical subtype was B in 75 patients and C in 16 patients. Twelve patie nts with localized disease received involved-field radiotherapy; seven patients without bulky disease had no initial therapy. The remaining 72 patients received long-term chlorambucil (9 patients), MOPP or COPB leo (42 patients), or a CHOP-derived regimen (21 patients). Forty-two patients (46%) achieved a complete remission (CR) and 28 patients (31% ) achieved a partial remission; 48 of these 70 patients relapsed or pr ogressed. Nineteen of the other 21 patients with stable LGFL progresse d. Two other patients failed to respond and rapidly died. Thirty-two o f the 67 patients with progressive or relapsed LGFL have died. Median overall survival was 111 months. Age greater-than-or-equal-to 70 years , male sex, B symptoms, histological subtype follicular mixed-cell NHL , tumor size greater-than-or-equal-to 10 cm, number of extranodal site s of disease greater-than-or-equal-to 2, pleural effusion, and Ann Arb or stage III or IV were found to adversely influence overall survival. Failure-free survival < 24 months, failure to achieve a CR after the progression, initial histological subtype follicular mixed cell, initi al Ann Arbor stage III or IV, and initial tumoral size greater-than-or -equal-to 10 cm were found to adversely influence survival after progr ession. Our results suggest that most prognostic factors for overall s urvival in LGFL are related to histological subtype or tumor burden. S ome initial adverse prognostic factors for survival may be also associ ated with a poor survival after progression.