Outcomes of Treatment in Slovene Follicular Lymphoma Patients

The treatment outcomes of follicular lymphoma (FL) patients have been positively influenced by the introduction of rituximab in the last 2 decades. A retrospective analysis of progression-free survival and overall survival of 278 routinely treated Slovene FL patients confirmed the significant benefit of adding rituximab to chemotherapy and into the maintenance setting outside clinical studies. Background: The outcome of follicular lymphoma (FL) patients has dramatically improved over the last 2 decades by introduction of rituximab in combination chemotherapy and into maintenance setting. We retrospectively analyzed the treatment outcomes in Slovene FL patients in the era of rituximab and compared them to the results reported by pivotal clinical studies. Patients and Methods: Two hundred seventy-eight patients with FL treated in Slovenia between 2000 and 2010 with a median follow-up of 5.7 years were included in our retrospective analysis. One hundred ninety-three (69%) received systemic treatment (ST). Results: With a median follow-up of 5.7 years, the 5- and 10-year overall survival (OS) rates for the whole series were 77% and 53%, respectively. The 5-year progression-free survival (PFS) for 193 FL patients treated with,ST was 37%. Patients treated with rituximab chemotherapy had a significantly better OS than patients treated with chemotherapy alone, with a 5-year OS of 79% versus 53% (hazard ratio [HR], 0.39; 95% confidence interval [Cl], 0.22-0.67; P = .001). Adding rituximab to the first-line chemotherapy significantly improved PFS compared to chemotherapy alone (HR, 0.26; 95% Cl 0.18-0.36; P < .001). Maintenance rituximab after immunochemotherapy in first-line treatment reduced the risk for progression by 61% and significantly prolonged the time to progression (HR, 0.39; 95% Cl 0.20-0.73; P < .003). Conclusion: The outcomes in our routinely treated FL patients confirm the benefit of adding rituximab to chemotherapy and are comparable to the results of pivotal clinical studies. The outcome of our FL patients was improved in terms of both PFS and OS.