The role of anthracyclines in combination chemotherapy for the treatment of follicular lymphoma: Retrospective study of the Intergruppo Italiano Linfomi on 761 cases

Luigi Rigacci, Massimo Federico, Maurizio Martelli, Pier Luigi Zinzani, Luigi Cavanna, Giampiero Bellesi, Francesco Merli, Renato Alterini, Maria Teresa Petrucci, Monica Tani, Anna Marina Liberati, Umberto Vitolo, Vincenzo Pavone, Antonio Cuneo, Teodoro Chisesi, Maura Brugiatelli

Research output: Contribution to journalArticlepeer-review

Abstract

In order to elucidate the role of anthracycline based combination chemotherapy regimens for the treatment of follicular lymphoma we conducted a retrospective study on a large series of patients with a histologically confirmed diagnosis of follicular lymphoma. The Italian lymphoma. intergroup (ILI) promoted a retrospective study of patients with follicular lymphoma treated in cooperative trials between 1985 and 1996. Six hundred and thirty three cases were treated with an anthracycline-containing regimen and 128 patients were treated without anthracyclines. The two groups were prognostically comparable; in particular, no difference was observed according to both IPI and ILI prognostic index. Results showed a complete remission (CR) rate for patients treated with anthracyclines was 69.2% and overall response rate was 92.5%. After a median follow-up of 51 months (54 months for patients still alive), the 5- and 10-year overall survival (OS) rates were 80 and 66%, respectively. Disease-free survival (DFS) and failure-free survival (FFS) rates at 5 years were 61 and 49%, respectively. In the group of patients treated with combination chemotherapy not including anthracyclines, the CR rate was 67.5% and the overall response rate was 85.4%. A longer OS (80% at 5 years) was observed in patients treated with anthracyclines compared to 67% OS rate in patients treated without anthracyclines (p = 0.0004). FFS was significantly longer in patients treated with anthracyclines (49 vs. 34% p = 0.006). Patients treated with anthracyclines with low or intermediate risk according to ILI prognostic index showed a significantly longer OS (p = 0.0001 and p = 0.0009, respectively); those in the high-risk group showed a trend for a longer survival. In conclusion, this retrospective study shows that patients with follicular lymphoma treated with an anthracycline containing regimen had a better outcome compared to patients treated with other combination regimens non including anthracyclines in terms of CRs, OS and FFS. On the basis of these results anthracycline-containing regimens (ACR) should be considered as the standard treatment of patients with advanced follicular lymphoma.

Original languageEnglish
Pages (from-to)1911-1917
Number of pages7
JournalLeukemia and Lymphoma
Volume44
Issue number11
DOIs
Publication statusPublished - Nov 2003

Keywords

  • Anthracycline containing regimen
  • Conventional chemotherapy
  • Disease-free survival
  • Follicular lymphoma

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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