Minimal residual disease after conventional treatment significantly impacts on progression-free survival of patients with follicular lymphoma: The FIL FOLL05 trial

Sara Galimberti, Stefano Luminari, Elena Ciabatti, Susanna Grassi, Francesca Guerrini, Alessra Dondi, Luigi Marcheselli, Marco Ladetto, Pier Paolo Piccaluga, Anna Gazzola, Claudia Mannu, Luigia Monitillo, Barbara Mantoan, Ilaria Del Giudice, Irene Della Starza, Marzia Cavalli, Luca Arcaini, Alessra Tucci, Giuseppe Alberto Palumbo, Luigi RigacciAlessro Pulsoni, Umberto Vitolo, Carola Boccomini, Daniele Vallisa, Giovanni Bertoldero, Gianluca Gaidano, Pellegrino Musto, Mario Petrini, Massimo Federico

Research output: Contribution to journalArticlepeer-review

Abstract

Experimental Design: DNAs from 415 patients among the 504 cases enrolled in the FOLL05 trial (NCT00774826) were centralized and assessed for the BCL2/IGH at diagnosis, at the end of treatment, and after 12 and 24 months.

Purpose: The role of the minimal residual disease (MRD) in follicular lymphoma is still debated. In this study, we assessed whether the BCL2/IGH rearrangement could have a prognostic role in patients receiving R-CHOP, R-FM, or R-CVP.

Results: At diagnosis, the molecular marker was detected in 53% of cases. Patients without molecular marker or with a low molecular tumor burden (4 copies) showed higher complete remission (CR) rate and longer progression-free survival (PFS; 3-year PFS 80% vs. 59%; P= 0.015). PFS was significantly conditioned by the PCR status at 12 and 24 months, with 3-year PFS of 66% for MRD- cases versus 41% for % at 12 months (P = 0.015), and 84% versus 50% at 24 months (P = 0.014). The MRD negativity those MRD+ at 12 and 24 months resulted in an improved PFS both in CR and in partial remission (PR) patients (3-year PFS = 72% for cases CR/PCR+ vs. 32% for those CR/PCR+ vs. 62% for those PR/PCR+ and 25% for patients in PR/PCR+; P = 0.001). The prognostic value ofMRDat 12 and 24 months of follow-up was confirmed also in multivariate analysis.

Conclusions: In this study, standardized molecular techniques have been adopted and applied on bone marrow samples from a large cohort. Data reported show that the MRD detection is a powerful independent predictor of PFS in patients with follicular lymphoma receiving conventional chemoimmunotherapy.

Original languageEnglish
Pages (from-to)6398-6405
Number of pages8
JournalClinical Cancer Research
Volume20
Issue number24
DOIs
Publication statusPublished - Dec 15 2014

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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