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13-year update of the R-HDS vs. CHOP-R trial in FL
Table 1. Main patient features at presentation according to last survival status
All Patients Patients
P
0.022 0.297
0.792
0.024
0.775
0.648
0.617
0.189
0.522
0.061
0.269
0.578
0.608
0.371
All
M/F
Age (y), median (range)
Histologic grade I-II,
n. (%)
age-adjusted IPI 2 or more, n. (%)
FLIPI 3 or more,
n. (%)
Ann Arbor stage IV, n (%)
B symptoms,
n. (%)
ECOG PS 2 or more, n. (%)
Bulky disease,
n. (%)
Spleen involvement,
n. (%)
Bone marrow involvement,
n (%)
Extranodal involvement,
n. (%)
Abnormal LDH,
n.(%)
Treatment arm (CHOP-R/R-HDS), n.
patients alive1 dead1
134 88 46
78/56 45/43 33/13 51 50 53 (22-59) (22-59) (35-59) 98 65 33 (73) (73) (71) 120 75 45 (89) (85) (98) 78 52 26 (58) (59) (56) 118 77 41 (88) (86) (89) 63 40 23 (47) (46) (50) 80 49 31 (60) (56) (67) 75 51 24 (56) (58) (52) 50 28 22 (37) (32) (48) 113 72 41 (84) (82) (89) 42 29 13 (31) (33) (28) 65 38 22 (59) (43) (48) 66/68 46/42 20/26
IPI: International Prognostic Index; FLIPI: follicular lymphoma IPI; n: number; M: male; F: female; ECOG: Eastern Cooperative Oncology Group; LDH: lactate dehydrogenase. 1Status
after 13 years of median follow up.
Complete remission and molecular response: achievement and durability
Complete remission was documented in 98 (73.1%) patients: 39 (59.1%) of 66 undergoing CHOP-R treatment and 59 (86.7%) of 68 R-HDS-treated patients. CR achieve- ment had a significantly favorable impact on survival, with 13-year OS estimates of 77.0% and 36.8%, for CR versus no-CR achievement, respectively (Figure 3A). Moreover, a durable CR was associated with prolonged survival. Overall, of 79 patients in CR at two years since treatment initiation, 65 (82.3%) were alive at 13 years compared to 21 (58.3%) among 36 patients with early relapse (P=0.003).
Molecular response was documented in 39 (65%) out of 60 evaluable patients: 11 (44%) of 25 undergoing CHOP- R treatment and 28 (80%) out of 35 R-HDS-treated patients (P<0.001).9 Again, MR achievement was associat- ed with a superior OS compared to patients not in MR fol- lowing treatment (13-year OS estimates of 82.1% and 51.9%, for MR vs. no-MR achievement, respectively) (Figure 3B).
Figure 1. Updated overall survival (OS) according to treatment arms. Intensive chemo-immunotherapy with autograft (R-HDS) versus conventional chemoim- munotherapy (CHOP-R). Median follow-up: 13 years. No: number; yrs: years.
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