Higher World Health Organization grades of follicular lymphoma correlate with better outcome in two Nordic Lymphoma Group trials of rituximab without chemotherapy
2014 (English)In: Leukemia and Lymphoma, ISSN 1042-8194, Vol. 55, no 2, 288-295 p.Article in journal (Refereed) Published
A common treatment for follicular lymphoma is rituximab monotherapy. To identify patients for whom this regimen is adequate as first-line therapy, we applied the World Health Organization (WHO) classification for grading follicular lymphoma in a prospective central pathology review of the biopsies of previously untreated patients in two randomized trials of rituximab without chemotherapy. In the first trial (n(1) = 53), higher WHO grades correlated with longer time to next treatment, independently of clinical prognostic factors (p = 0.030); the finding was replicated in the second trial (n(2) = 221; p = 0.019). Higher grades were associated with better treatment responses (p = 0.018). Furthermore, also grades externally confirmed by independent local pathologists correlated with time to next treatment (p = 0.048). Flow cytometry in a separate patient series showed that the intensity of CD20 increased with the malignant cell size (p < 0.00005). In conclusion, WHO grade 1 follicular lymphoma correlates with inferior outcome after rituximab monotherapy. WHO grading might provide a clinically useful tool for personalized therapy.
Place, publisher, year, edition, pages
2014. Vol. 55, no 2, 288-295 p.
Follicular lymphoma, WHO, grades, rituximab, CD20
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-221985DOI: 10.3109/10428194.2013.802778ISI: 000330733100012OAI: oai:DiVA.org:uu-221985DiVA: diva2:710526