Clinical efficiency of frontline RCHOP regimen in treatment of follicular lymphoma grade 3 patients with different histological subtypes

Objective To explore the clinical features and outcomes of follicular lymphoma (FL) grade 3 treated with frontline RCHOP regimen.

Methods 61 FL grade 3 patients treated with frontline RCHOP regimen between January 2009 and December 2019 were retrospectively analyzed. We divided them into FL grade 3A (n=42) and aggressive FL (n=19). Aggressive FL included grade 3A with an additional 3B component (n=2), grade 3B (n=8), and grade 3 with areas of diffuse large B cell lymphoma (n=9).

Results The baseline characteristics, including gender, age, serum β₂ microglobulin and lactate dehydrogenase levels, Ann Arbor stage, B symptom and bone marrow involvement were similar between FL grade 3A and aggressive FL. After a median follow-up period of 40.2 months, the 3-year overall survival (OS) rate was 97.1% in FL grade 3A and 81.9% in aggressive FL, (P=0.041). The 3-year progression free survival (PFS) rate was 69.1% and 71.1%, respectively, (P=0.546). Patients of aggressive FL reached a plateau in the PFS curve after 2 years.

Conclusions The 3-year OS survival rate of the frontline RCHOP regimen in the treatment of FL3A patients was better than that of aggressive FL, but the PFS difference between the two was not statistically significant. PFS plateau appears after 2 years of treatment in aggressive FL patients.