Prolonged survival in the absence of disease-recurrence in advanced-stage follicular lymphoma following chemo-immunotherapy: 13-year update of the prospective, multicenter randomized GITMO-IIL trial

Riccardo Bruna, Fabio Benedetti, Carola Boccomini, Caterina Patti, Anna Maria Barbui, Alessandro Pulsoni, Maurizio Musso, Anna Marina Liberati, Guido Gini, Claudia Castellino, Fausto Rossini, Fabio Ciceri, Delia Rota-Scalabrini, Caterina Stelitano, Francesco Di Raimondo, Alessandra Tucci, Liliana Devizzi, Valerio Zoli, Francesco Zallio, Franco NarniAlessandra Dondi, Guido Parvis, Gianpietro Semenzato, Francesco Lanza, Tommasina Perrone, Francesco Angrilli, Atto Billio, Angela Gueli, Barbara Mantoan, Alessandro Rambaldi, Alessandro Massimo Gianni, Paolo Corradini, Roberto Passera, Marco Ladetto, Corrado Tarella

Research output: Contribution to journalArticle

Abstract

Aprospective trial conducted in the period 2000-2005 showed no survival advantage for high-dose chemotherapy with rituximab and autograft (RHDS) versus conventional chemotherapy with rituximab (CHOP-R) as firstline therapy in 134 high-risk follicular lymphoma patients aged <60 years. The study has been updated at the 13-year median follow up. As of February 2017, 88 (66%) patients were alive, with overall survival of 66.4% at 13 years, without a significant difference between R-HDS (64.5%) and CHOP-R (68.5%). To date, 46 patients have died, mainly because of disease progression (47.8% of all deaths), secondary malignancies (3 solid tumor, 9 myelodysplasia/acute leukemia; 26.1% of all deaths), and other toxicities (21.7% of all deaths). Complete remission was documented in 98 (73.1%) patients and associated with overall survival, with 13- year estimates of 77.0% and 36.8% for complete remission versus no-complete remission, respectively. Molecular remission was documented in 39 (65%) out of 60 evaluable patients and associated with improved survival. In multivariate analysis, complete remission achievement had the strongest effect on survival (P<0.001), along with younger age (P=0.002) and female sex (P=0.013). Overall, 50 patients (37.3%) survived with no disease recurrence (18 CHOP-R, 32 R-HDS). This follow up is the longest reported on follicular lymphoma treated upfront with rituximab-chemotherapy and demonstrates an unprecedented improvement in survival compared to the pre-rituximab era, regardless of the use of intensified or conventional treatment. Complete remission was the most important factor for prolonged survival and a high proportion of patients had prolonged survival in their first remission, raising the issue of curability in follicular lymphoma.

Original languageEnglish
Pages (from-to)2241-2248
Number of pages8
JournalHaematologica
Volume104
Issue number11
DOIs
Publication statusPublished - Jan 1 2019

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Follicular Lymphoma
Immunotherapy
Recurrence
Survival
Drug Therapy
Autografts
Disease Progression
Rituximab
Neoplasms
Leukemia
Multivariate Analysis
Therapeutics

ASJC Scopus subject areas

  • Hematology

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Prolonged survival in the absence of disease-recurrence in advanced-stage follicular lymphoma following chemo-immunotherapy : 13-year update of the prospective, multicenter randomized GITMO-IIL trial. / Bruna, Riccardo; Benedetti, Fabio; Boccomini, Carola; Patti, Caterina; Barbui, Anna Maria; Pulsoni, Alessandro; Musso, Maurizio; Liberati, Anna Marina; Gini, Guido; Castellino, Claudia; Rossini, Fausto; Ciceri, Fabio; Rota-Scalabrini, Delia; Stelitano, Caterina; Di Raimondo, Francesco; Tucci, Alessandra; Devizzi, Liliana; Zoli, Valerio; Zallio, Francesco; Narni, Franco; Dondi, Alessandra; Parvis, Guido; Semenzato, Gianpietro; Lanza, Francesco; Perrone, Tommasina; Angrilli, Francesco; Billio, Atto; Gueli, Angela; Mantoan, Barbara; Rambaldi, Alessandro; Massimo Gianni, Alessandro; Corradini, Paolo; Passera, Roberto; Ladetto, Marco; Tarella, Corrado.

In: Haematologica, Vol. 104, No. 11, 01.01.2019, p. 2241-2248.

Research output: Contribution to journalArticle

Bruna, R, Benedetti, F, Boccomini, C, Patti, C, Barbui, AM, Pulsoni, A, Musso, M, Liberati, AM, Gini, G, Castellino, C, Rossini, F, Ciceri, F, Rota-Scalabrini, D, Stelitano, C, Di Raimondo, F, Tucci, A, Devizzi, L, Zoli, V, Zallio, F, Narni, F, Dondi, A, Parvis, G, Semenzato, G, Lanza, F, Perrone, T, Angrilli, F, Billio, A, Gueli, A, Mantoan, B, Rambaldi, A, Massimo Gianni, A, Corradini, P, Passera, R, Ladetto, M & Tarella, C 2019, 'Prolonged survival in the absence of disease-recurrence in advanced-stage follicular lymphoma following chemo-immunotherapy: 13-year update of the prospective, multicenter randomized GITMO-IIL trial', Haematologica, vol. 104, no. 11, pp. 2241-2248. https://doi.org/10.3324/haematol.2018.209932
Bruna, Riccardo ; Benedetti, Fabio ; Boccomini, Carola ; Patti, Caterina ; Barbui, Anna Maria ; Pulsoni, Alessandro ; Musso, Maurizio ; Liberati, Anna Marina ; Gini, Guido ; Castellino, Claudia ; Rossini, Fausto ; Ciceri, Fabio ; Rota-Scalabrini, Delia ; Stelitano, Caterina ; Di Raimondo, Francesco ; Tucci, Alessandra ; Devizzi, Liliana ; Zoli, Valerio ; Zallio, Francesco ; Narni, Franco ; Dondi, Alessandra ; Parvis, Guido ; Semenzato, Gianpietro ; Lanza, Francesco ; Perrone, Tommasina ; Angrilli, Francesco ; Billio, Atto ; Gueli, Angela ; Mantoan, Barbara ; Rambaldi, Alessandro ; Massimo Gianni, Alessandro ; Corradini, Paolo ; Passera, Roberto ; Ladetto, Marco ; Tarella, Corrado. / Prolonged survival in the absence of disease-recurrence in advanced-stage follicular lymphoma following chemo-immunotherapy : 13-year update of the prospective, multicenter randomized GITMO-IIL trial. In: Haematologica. 2019 ; Vol. 104, No. 11. pp. 2241-2248.
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abstract = "Aprospective trial conducted in the period 2000-2005 showed no survival advantage for high-dose chemotherapy with rituximab and autograft (RHDS) versus conventional chemotherapy with rituximab (CHOP-R) as firstline therapy in 134 high-risk follicular lymphoma patients aged <60 years. The study has been updated at the 13-year median follow up. As of February 2017, 88 (66{\%}) patients were alive, with overall survival of 66.4{\%} at 13 years, without a significant difference between R-HDS (64.5{\%}) and CHOP-R (68.5{\%}). To date, 46 patients have died, mainly because of disease progression (47.8{\%} of all deaths), secondary malignancies (3 solid tumor, 9 myelodysplasia/acute leukemia; 26.1{\%} of all deaths), and other toxicities (21.7{\%} of all deaths). Complete remission was documented in 98 (73.1{\%}) patients and associated with overall survival, with 13- year estimates of 77.0{\%} and 36.8{\%} for complete remission versus no-complete remission, respectively. Molecular remission was documented in 39 (65{\%}) out of 60 evaluable patients and associated with improved survival. In multivariate analysis, complete remission achievement had the strongest effect on survival (P<0.001), along with younger age (P=0.002) and female sex (P=0.013). Overall, 50 patients (37.3{\%}) survived with no disease recurrence (18 CHOP-R, 32 R-HDS). This follow up is the longest reported on follicular lymphoma treated upfront with rituximab-chemotherapy and demonstrates an unprecedented improvement in survival compared to the pre-rituximab era, regardless of the use of intensified or conventional treatment. Complete remission was the most important factor for prolonged survival and a high proportion of patients had prolonged survival in their first remission, raising the issue of curability in follicular lymphoma.",
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T1 - Prolonged survival in the absence of disease-recurrence in advanced-stage follicular lymphoma following chemo-immunotherapy

T2 - 13-year update of the prospective, multicenter randomized GITMO-IIL trial

AU - Bruna, Riccardo

AU - Benedetti, Fabio

AU - Boccomini, Carola

AU - Patti, Caterina

AU - Barbui, Anna Maria

AU - Pulsoni, Alessandro

AU - Musso, Maurizio

AU - Liberati, Anna Marina

AU - Gini, Guido

AU - Castellino, Claudia

AU - Rossini, Fausto

AU - Ciceri, Fabio

AU - Rota-Scalabrini, Delia

AU - Stelitano, Caterina

AU - Di Raimondo, Francesco

AU - Tucci, Alessandra

AU - Devizzi, Liliana

AU - Zoli, Valerio

AU - Zallio, Francesco

AU - Narni, Franco

AU - Dondi, Alessandra

AU - Parvis, Guido

AU - Semenzato, Gianpietro

AU - Lanza, Francesco

AU - Perrone, Tommasina

AU - Angrilli, Francesco

AU - Billio, Atto

AU - Gueli, Angela

AU - Mantoan, Barbara

AU - Rambaldi, Alessandro

AU - Massimo Gianni, Alessandro

AU - Corradini, Paolo

AU - Passera, Roberto

AU - Ladetto, Marco

AU - Tarella, Corrado

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aprospective trial conducted in the period 2000-2005 showed no survival advantage for high-dose chemotherapy with rituximab and autograft (RHDS) versus conventional chemotherapy with rituximab (CHOP-R) as firstline therapy in 134 high-risk follicular lymphoma patients aged <60 years. The study has been updated at the 13-year median follow up. As of February 2017, 88 (66%) patients were alive, with overall survival of 66.4% at 13 years, without a significant difference between R-HDS (64.5%) and CHOP-R (68.5%). To date, 46 patients have died, mainly because of disease progression (47.8% of all deaths), secondary malignancies (3 solid tumor, 9 myelodysplasia/acute leukemia; 26.1% of all deaths), and other toxicities (21.7% of all deaths). Complete remission was documented in 98 (73.1%) patients and associated with overall survival, with 13- year estimates of 77.0% and 36.8% for complete remission versus no-complete remission, respectively. Molecular remission was documented in 39 (65%) out of 60 evaluable patients and associated with improved survival. In multivariate analysis, complete remission achievement had the strongest effect on survival (P<0.001), along with younger age (P=0.002) and female sex (P=0.013). Overall, 50 patients (37.3%) survived with no disease recurrence (18 CHOP-R, 32 R-HDS). This follow up is the longest reported on follicular lymphoma treated upfront with rituximab-chemotherapy and demonstrates an unprecedented improvement in survival compared to the pre-rituximab era, regardless of the use of intensified or conventional treatment. Complete remission was the most important factor for prolonged survival and a high proportion of patients had prolonged survival in their first remission, raising the issue of curability in follicular lymphoma.

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