Evolution of approaches to follicular lymphoma therapy at disease onset and first relapse Twenty-five-year experience of the National Medical Research Center for Hematology

Newly diagnosed and relapsed follicular lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

IBCL-409 The Expediency of Early Administration of Second-Line Therapy to Patients in Partial Remission of Follicular Lymphoma

Difference of Relapse Pattern Between Nodal and Gastrointestinal Follicular Lymphomas

A SWOT-Consensus for CAR-T in Follicular Lymphoma: Fine Tuning of Patient Journey and Selection

Biological characterization of stage I follicular lymphoma according to extranodal or nodal primary origin and t(14;18) status using high-resolution array-based comparative genomic hybridization.

Progression-Free Survival at 24 Months (PFS24) and Complete Response at 30 Months (CR30) from Autologous Stem Cell Transplantation (ASCT) Should be Used As Surrogates for OS in Follicular Lymphoma (FL) Patients

Combination of High Serum Lactate Dehydrogenase Levels at the Time of First Diagnosis and Progression Predicts Early Lymphoma Related Death in Patients with Follicular Lymphoma Receiving R-CHOP Regimen

Genetic and Microenvironment Features Do Not Distinguish Follicular Lymphoma Patients Requiring Immediate or Deferred Treatment.

Background/Objectives: This study aimed to determine whether interim PET/CT (iPET) scans could identify follicular lymphoma (FL) patients at high risk of relapse following first-line therapy. Methods: A total of 117 FL patients who underwent iPET scans were included, with responses interpreted using the Deauville score (DS). Progression-free survival (PFS) was evaluated over a median follow-up of 34 months. Results: Overall, 34% of patients were classified as iPET (+), with significantly worse estimated 5-year PFS compared to iPET (-) patients (34% vs. 76%, hazard ratio 4.3, p < 0.001). Multivariate analysis confirmed iPET (+) as an independent predictor of PFS. Conclusions: Interim PET results are significant predictors of PFS in FL first-line therapy and could inform response-adapted treatment strategies.

Evaluation of T-Cell Compartment By Complex Multiparameter Flow Cytometry Reveals Distinct Patterns of T-Cell Exhaustion in DLBCL, FL and HL Patients

Newly diagnosed and relapsed follicular lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

7502 Background: Chemoresistant patients with FL and those who progress within 2 y after initial diagnosis have poor outcomes (Casulo. JCO. 2015) and highlight an unmet need. Methods: MAGNIFY (NCT01996865) is a phase IIIb, multicenter, open-label study of relapsed/refractory (R/R) NHL patients, including grades 1-3b or transformed FL (tFL). Patients receive 12 cycles of lenalidomide plus rituximab (R2); those with stable disease or better are randomized 1:1 to maintenance R2 or rituximab alone. The primary endpoint is progression-free survival (PFS). This analysis focuses on FL: double-refractory (DR) patients are refractory to both rituximab (as monotherapy or combination) and an alkylating agent, and early relapse (ER) patients progressed or relapsed within 2 y of initial diagnosis. Results: As of July 19, 2016, the R/R FL population (N = 117) included 32 (27%) DR and 43 (37%) ER patients, median ages of 64 and 65 y, respectively, mostly grade 1-3a FL (94%; 91%) and 2 tFL (1 DR; 1 ER); 72% and 49% were stage IV at study entry. Patients had a median of 2 prior regimens (DR 3; ER 2). Of ER patients, 31 had first-line R-chemo vs 12 with R-mono/other. Response rates are in Table 1. Median time to response was 2.8 mo for DR and 2.7 mo for ER patients, with median duration not reached. 1-y PFS for FL patients was 66% (DR 66%; ER 45%); 1-y PFS for ER patients with first-line R-chemo was 50% vs 27% in others. Common grade ≥3 treatment-emergent AEs for DR and ER patients were neutropenia (53%; 33%), leukopenia (9%; 12%), and lymphopenia (9%; 5%). Conclusions: R2 followed by maintenance showed favorable activity and tolerable safety profiles in FL patients who are double-refractory or had early relapse ( &lt; 2 years) after initial diagnosis. Enrollment in MAGNIFY is ongoing. Clinical trial information: NCT01996865. [Table: see text]

Bioflipi scores define distinct immune profiles in follicular lymphoma

Follicular lymphoma (FL) spans both nodal and extranodal sites, with molecular characteristics that may vary by anatomical location. While nodal FL typically shows BCL2 rearrangement and frequent chromatin-modifying gene mutations (CREBBP, KMT2D), some extranodal FLs lack t(14;18)(q32:q21) and harbour distinct alterations, such as TNFRSF14 mutations. In our retrospective series of 23 ocular adnexal FL (OA FL) cases that include both primary and secondary involvement, an approximately equal distribution of BCL2-rearranged and non-rearranged cases was observed, underlining that the ocular localisation displays features of both conventional nodal and extranodal FL. Mutational analysis revealed a mix of mutations commonly seen in nodal and extranodal FL, with strong CD23 expression correlating with JAK/STAT pathway gene mutations. Most OA FLs followed an indolent course with good outcomes after local therapy, though transformation to diffuse large B-cell lymphoma occurred in a subset of two cases. Our results suggest that OA FL exhibits genetic heterogeneity, combining molecular features from both subtypes, and highlight the importance of thorough staging and individualised therapeutic and surveillance strategies for each patient.

Statin Use and Prognosis in Patients with Follicular Lymphoma (FL) and Diffuse Large B Cell Lymphoma (DLBCL)