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Higher World Health Organization grades of follicular lymphoma correlate with better outcome in two Nordic Lymphoma Group trials of rituximab without chemotherapy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Molecular and Morphological Pathology.
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2014 (English)In: Leukemia and Lymphoma, ISSN 1042-8194, Vol. 55, no 2, 288-295 p.Article in journal (Refereed) Published
Abstract [en]

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.
Keyword [en]
Follicular lymphoma, WHO, grades, rituximab, CD20
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-221985DOI: 10.3109/10428194.2013.802778ISI: 000330733100012OAI: oai:DiVA.org:uu-221985DiVA: diva2:710526
Available from: 2014-04-07 Created: 2014-04-07 Last updated: 2014-04-07Bibliographically approved

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Sundström, Christer
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