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Leich E, Brodtkorb M, Schmidt T, Altenbuchinger M, Lingjærde OC, Lockmer S, Holte H, Nedeva T, Grieb T, Sander B, Sundström C, Spang R, Kimby E, Rosenwald A. Gene expression and copy number profiling of follicular lymphoma biopsies from patients treated with first-line rituximab without chemotherapy. Leuk Lymphoma 2023; 64:1927-1937. [PMID: 37683053 DOI: 10.1080/10428194.2023.2240462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 09/10/2023]
Abstract
The Nordic Lymphoma Study Group has performed two randomized clinical trials with chemotherapy-free first-line treatment (rituximab +/- interferon) in follicular lymphoma (FL), with 73% of patients alive and 38% without any need of chemotherapy after 10.6 years median follow-up. In order to identify predictive markers, that may also serve as therapeutic targets, gene expression- and copy number profiles were obtained from 97 FL patients using whole genome microarrays. Copy number alterations (CNAs) were identified, e.g. by GISTIC. Cox Lasso Regression and Lasso logistic regression were used to determine molecular features predictive of time to next therapy (TTNT). A few molecular changes were associated with TTNT (e.g. increased expression of INPP5B, gains in 12q23/q24), but were not significant after adjusting for multiple testing. Our findings suggest that there are no strong determinants of patient outcome with respect to GE data and CNAs in FL patients treated with a chemotherapy-free regimen (i.e. rituximab +/- interferon).
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Affiliation(s)
- E Leich
- Institute of Pathology, University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | | | - T Schmidt
- Statistical Bioinformatics, Institute of Functional Genomics, University of Regensburg, Regensburg, Germany
| | - M Altenbuchinger
- Statistical Bioinformatics, Institute of Functional Genomics, University of Regensburg, Regensburg, Germany
- Department of Medical Bioinformatics, University Medical Center Göttingen, Göttingen, Germany
| | - Ole Christian Lingjærde
- Division of Biomedical Informatics, Department of Computer Science, University of Oslo, Norway
| | - S Lockmer
- Division of Hematology, Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - H Holte
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - T Nedeva
- Institute of Pathology, University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - T Grieb
- Institute of Pathology, University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - B Sander
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden
| | - C Sundström
- Department of Pathology, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - R Spang
- Statistical Bioinformatics, Institute of Functional Genomics, University of Regensburg, Regensburg, Germany
| | - E Kimby
- Division of Hematology, Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A Rosenwald
- Institute of Pathology, University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
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2
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Nahi H, Afram G, Uttervall K, Lockmer S, Tätting L, Gahrton G, Kashif M, Alici E, Stromberg O, Klimkowska M, Lund J. Minimal residual disease status is the prognostic determinant following high-dose treatment for patients with multiple myeloma. Cancer Med 2023; 12:20736-20744. [PMID: 37921243 PMCID: PMC10709722 DOI: 10.1002/cam4.6640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/30/2023] [Accepted: 09/30/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND The presence of minimal residual disease (MRD+) following autologous stem cell transplantation (ASCT) in multiple myeloma represents a poor prognostic factor for progression-free survival (PFS) and overall survival (OS). METHODS At our department, we recommend lenalidomide maintenance for patients who are MRD+ after ASCT, while MRD-negative (MRD-) patients, after information about the national guidelines, were not advised to follow this regimen. RESULTS Out of the total 228 patients, 175 received ASCT following first-line induction (MRD- 92 (53%), MRD+ 83 (47%), at 2 months post-ASCT), while 53 underwent ASCT after second-line treatment (MRD- 27 (51%), MRD+ 26 (49%), at the same time point). Comparatively, MRD- patients who did not receive maintenance demonstrated better OS than MRD+ patients who received upfront ASCT and maintenance treatment (96% vs. 86%, p = 0.030, at 3 years). However, nonsignificant difference was found in PFS (76% vs. 62%, at 3 years). Furthermore, second-line ASCT, MRD- non-maintained patients exhibited significantly better PFS than MRD+ (71% vs. 27%, p > 0.001, at 3 years). However, OS was better but nonsignificant (96% vs. 76%, at 3 years). Fluorescence in situ hybridization (FISH) analysis was performed on 141 out of the 228 patients. Of these, 85 (60%) patients were deemed standard risk (SR), and 56 (40%) were classified as high risk (HR). In the SR cohort, MRD- patients exhibited better PFS and OS than MRD+ patients (71% vs. 59% and 100% vs. 85%, respectively). In the HR cohort, the MRD- patients showed superior PFS but similar OS compared to MRD+ patients (66% vs. 42% and 81% vs. 80%, respectively). CONCLUSIONS Our results indicate that being MRD- is a more crucial prognostic factor for the 3-year PFS and OS than the presence of high-risk cytogenetic markers or undergoing maintenance treatment. The latter appears insufficient, particularly for MRD+ patients following ASCT in the second-line setting, suggesting that these patients may require a more intensive treatment approach.
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Affiliation(s)
- Hareth Nahi
- Department of MedicineInstitution for biomedicine and clinical scienceLinköpingSweden
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
| | - Gabriel Afram
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
| | - Katarina Uttervall
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
| | - Sandra Lockmer
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
| | - Love Tätting
- Department of MedicineInstitution for biomedicine and clinical scienceLinköpingSweden
| | - Gösta Gahrton
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
| | - Muhammad Kashif
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
| | - Evren Alici
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
| | | | - Monika Klimkowska
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
| | - Johan Lund
- Center for Hematology and Regenerative Medicine, Department of Medicine, HuddingeKarolinska InstitutetStockholmSweden
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3
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Stevens WBC, Los-de Vries GT, Langois-Jacques C, Clear AJ, Stathi P, Sander B, Rosenwald A, Calaminici M, Hoster E, Hiddemann W, Gaulard P, Salles G, Klapper W, Xerri L, Burton C, Tooze RM, Smith AG, Buske C, Scott DW, Natkunam Y, Advani R, Sehn LH, Raemaekers J, Gribben J, Lockmer S, Kimby E, Kersten MJ, Maucort-Boulch D, Ylstra B, van Dijk E, de Jong D. Genetic and Microenvironment Features Do Not Distinguish Follicular Lymphoma Patients Requiring Immediate or Deferred Treatment. Hemasphere 2023; 7:e863. [PMID: 37038467 PMCID: PMC10082297 DOI: 10.1097/hs9.0000000000000863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/06/2023] [Indexed: 04/08/2023] Open
Affiliation(s)
| | - G. Tjitske Los-de Vries
- Department of Pathology, Amsterdam UMC location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - Carole Langois-Jacques
- Université Lyon 1, Villeurbanne, France
- CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
| | - Andrew J. Clear
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary, University of London, United Kingdom
| | - Phylicia Stathi
- Department of Pathology, Amsterdam UMC location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - Birgitta Sander
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Maria Calaminici
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary, University of London, United Kingdom
| | - Eva Hoster
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU University, Munich, Germany
- Department of Medicine III, LMU University Hospital, Munich, Germany
| | | | - Philippe Gaulard
- Department of Pathology, Henri Mondor University Hospital, APHP, INSERM U955, Université Paris-Est, Créteil, France
| | - Gilles Salles
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Wolfram Klapper
- Institute of Pathology, University of Schleswig-Holstein, Kiel, Germany
| | - Luc Xerri
- Département de Biopathologie, Institut Paoli-Calmettes, Marseille, France
| | - Catherine Burton
- Haematological Malignancy Diagnostic Service, St James University Hospital, Leeds, United Kingdom
| | - Reuben M. Tooze
- Division of Haematology & Immunology, Leeds Institute of Medical Research, University of Leeds, United Kingdom
| | - Alexandra G. Smith
- Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, United Kingdom
| | - Christian Buske
- Institute of Experimental Cancer Research, CCC Ulm, Universitäts Klinikum Ulm, Germany
| | - David W. Scott
- BC Cancer Centre for Lymphoid Cancer and The University of British Columbia, Vancouver, BC, Canada
| | - Yasodha Natkunam
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford, CA, USA
| | - Ranjana Advani
- Stanford Cancer Institute, Stanford, CA, USA
- Department of Hematology, Stanford University School of Medicine, Stanford, CA, USA
| | - Laurie H. Sehn
- BC Cancer Centre for Lymphoid Cancer and The University of British Columbia, Vancouver, BC, Canada
| | - John Raemaekers
- Department of Hematology, Radboud UMC Nijmegen, the Netherlands
| | - John Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary, University of London, United Kingdom
| | - Sandra Lockmer
- Division of Hematology, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Eva Kimby
- Division of Hematology, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Marie José Kersten
- Department of Hematology, Amsterdam UMC location University of Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - Delphine Maucort-Boulch
- Université Lyon 1, Villeurbanne, France
- CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
| | - Bauke Ylstra
- Department of Pathology, Amsterdam UMC location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - Erik van Dijk
- Department of Pathology, Amsterdam UMC location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - Daphne de Jong
- Department of Pathology, Amsterdam UMC location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, the Netherlands
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Kiserud CE, Lockmer S, Baerug I, Dahl AA, Kimby E, Østenstad B. Health-related quality of life and chronic fatigue in long-term survivors of indolent lymphoma - a comparison with normative data. Leuk Lymphoma 2023; 64:349-355. [PMID: 36342349 DOI: 10.1080/10428194.2022.2142050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aims of this study are to describe health-related quality of life (HRQoL, SF-36) and fatigue in long-term indolent lymphoma survivors, compared to normative data, and to examine factors related to impaired HRQoL among the survivors. The participants (N = 136, median follow-up after first line therapy 9.8 years) were included from a follow-up study of two clinical trials, with chemo-free first-line therapy. The present survey included questionnaire based data. Compared to the normative data, the mean total fatigue score were higher, and HRQoL lower in 4 of 8 domains among the lymphoma survivors. Among the survivors, somatic comorbidities, not being in paid work and chronic fatigue were significantly associated with reduced physical HRQoL. Anxiety and depressive symptoms were associated with reduced mental HRQoL. Our findings highlight the need for awareness of HRQoL and fatigue in long term follow up in lymphoma survivors, as there are treatments and rehabilitation options.
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Affiliation(s)
- Cecilie E Kiserud
- National Advisory Unit for Late Effects after Cancer, Oslo University Hospital, Oslo, Norway
| | - Sandra Lockmer
- Department of Medicine, Center for Hematology and Regenerative Medicine, Stockholm, Sweden.,Karolinska Institutet, and Hematology Center, Karolinska University Hospital, Stockholm, Sweden
| | - Idun Baerug
- National Advisory Unit for Late Effects after Cancer, Oslo University Hospital, Oslo, Norway
| | - Alv A Dahl
- National Advisory Unit for Late Effects after Cancer, Oslo University Hospital, Oslo, Norway
| | - Eva Kimby
- Department of Medicine,Unit of Hematology, Karolinska Institutet, Stockholm, Sweden
| | - Bjørn Østenstad
- Department of Oncology, Oslo University Hospital, Oslo, Norway
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5
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Lockmer S, Uttervall K, Kashif M, Svärd C, Malmsten K, Fletcher‐Torres E, Alici E, Lund J, Nahi H. Antibody response to COVID-19 mRNA vaccine (Comirnaty) in myeloma patients treated with high-dose melphalan and/or immunotherapy. Am J Hematol 2021; 96:E443-E446. [PMID: 34524709 PMCID: PMC8646781 DOI: 10.1002/ajh.26348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/30/2021] [Accepted: 09/07/2021] [Indexed: 01/15/2023]
Affiliation(s)
- Sandra Lockmer
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge Karolinska Institutet Stockholm Sweden
- Hematology Center Karolinska University Hospital Stockholm Sweden
| | - Katarina Uttervall
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge Karolinska Institutet Stockholm Sweden
- Hematology Center Karolinska University Hospital Stockholm Sweden
| | - Muhammad Kashif
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge Karolinska Institutet Stockholm Sweden
| | - Carina Svärd
- Hematology Center Karolinska University Hospital Stockholm Sweden
| | | | | | - Evren Alici
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge Karolinska Institutet Stockholm Sweden
- Hematology Center Karolinska University Hospital Stockholm Sweden
| | - Johan Lund
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge Karolinska Institutet Stockholm Sweden
- Hematology Center Karolinska University Hospital Stockholm Sweden
| | - Hareth Nahi
- Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge Karolinska Institutet Stockholm Sweden
- Hematology Center Karolinska University Hospital Stockholm Sweden
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6
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Alonso-Álvarez S, Manni M, Montoto S, Sarkozy C, Morschhauser F, Wondergem MJ, Guarini A, Magnano L, Alcoceba M, Chamuleau M, Galimberti S, Gomes da Silva M, Holte H, Zucca E, Lockmer S, Aurer I, Marcheselli L, Stepanishyna Y, Caballero Barrigón MD, Salles G, Federico M. Primary refractory follicular lymphoma: a poor outcome entity with high risk of transformation to aggressive B cell lymphoma. Eur J Cancer 2021; 157:132-139. [PMID: 34508995 DOI: 10.1016/j.ejca.2021.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 07/28/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Primary refractory (PREF) follicular lymphoma (FL) has a completely different clinical course from that of FL that responds to front-line treatments. In addition to having poor responses to salvage therapies, it seems that patients with PREF are at increased risk of histological transformation (HT). The Aristotle consortium presented the opportunity of investigating the risk of HT in a very large series of cases. Thus, we investigated the risk of HT in patients with PREF FL compared with that of responding patients or in stable disease and ultimately their outcome. METHODS Six thousand three hundred thirty-nine patients from the Aristotle database were included in the analysis. These patients had a histologically confirmed grade 1, 2 or 3a FL diagnosed between 1997 and 2013. The primary end-points were the cumulative incidence (CI) of HT at the first progression or relapse and the survival after transformation. FINDINGS The 5-year CI of HT among patients with PREF was 34% (95% confidence interval (CI): 27-43), whilst it was 7.1% (95% CI: 6.0-8.5) in the group of patients with partial response (PR) or stable disease (SD) (PR + SD) and 3.5% (95% CI: 3.0-4.2) in the group of patients achieving complete response (CR). The 5-year survival after relapse (SAR) was 33% (95% CI: 28-39) for the PREF group, 57% (95% CI 54-61) in patients with PR, 51% (95% CI 43-58) in the SD group after first-line therapy and 63% (95% CI: 66-72) in patients with CR after initial treatment (p-value <0.001). The 5-year SAR for those patients with PREF who developed HT was 21% (95% CI: 12-31), clearly diminished when compared with those patients with PREF who did not experience HT (38% [95% CI: 31-44]) (p-value = 0.001). INTERPRETATION Patients with PREF FL have a dismal outcome and an associated very high rate of HT that further worsens their poor prognosis.
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Affiliation(s)
- Sara Alonso-Álvarez
- Department of Haematology, Hospital Universitario Central de Asturias, Spain.
| | - Martina Manni
- CHIMOMODepartment, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Montoto
- St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Clémentine Sarkozy
- INSERM 1052, Charles Mérieux Lyon-1 Faculty, Claude Bernard University, Lyon, France
| | - Franck Morschhauser
- Department of Clinical Haematology, CHU Lille, Unite GRITA, Universite de Lille 2, Lille, France
| | - Marielle J Wondergem
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Attilio Guarini
- Haematology Unit, IRCCS IstitutoTumori "Giovanni Paolo II", Bari, Italy
| | - Laura Magnano
- Department of Haematology, Hospital Clinic of Barcelona, Spain
| | - Miguel Alcoceba
- Department of Hematology, Hospitalario Universitario de Salamanca (HUS/IBSAL) and CIBERONC, Salamanca, Spain
| | - Martine Chamuleau
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Harald Holte
- Department of Oncology, Radiumhospitalet, Oslo University Hospital, Norway
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland
| | - Sandra Lockmer
- Dep. of Hematology, Karolinska University Hospital and Dep. of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Igor Aurer
- Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb and Medical School, University of Zagreb, Croatia
| | | | - Yana Stepanishyna
- CHIMOMODepartment, University of Modena and Reggio Emilia, Modena, Italy; Department of Oncohematology, National Cancer Institute, Kiev, Ukraine
| | | | - Gilles Salles
- Gilles SALLES, Lymphoma Service, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Massimo Federico
- CHIMOMODepartment, University of Modena and Reggio Emilia, Modena, Italy
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7
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Junlén HR, Lockmer S, Kimby E, Wahlin BE. Absolute B cell counts in blood predict long-term response in follicular lymphoma patients treated with rituximab without chemotherapy. Ann Hematol 2020; 99:2357-2366. [PMID: 32808106 PMCID: PMC7481163 DOI: 10.1007/s00277-020-04208-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
Rituximab monotherapy is widely used for follicular lymphoma. However, there are no established predictors for response or response duration. We analyzed the long-term prognostic relevance of pre-treatment absolute blood counts of lymphocytes with subsets and monocytes in 265 follicular lymphoma patients, uniformly treated with rituximab without chemotherapy, in two Nordic Lymphoma Group trials. There were 265 previously untreated, stage II–IV follicular lymphoma patients with a median follow-up of over 10 years. Absolute B cell counts ≥ median (0.09 × 109/L) were an independent predictor for shorter time to next treatment or death (multivariable analysis P = 0.010). In univariate analysis, absolute monocyte counts ≥ median (0.5 × 109/L) did not correlate with time to next treatment or death, but with inferior overall survival (P = 0.034). Absolute T cell or T cell subset counts were not predictive for outcome. High absolute B cell counts, possibly reflecting circulating lymphoma cells, have an unfavorable impact on time to next treatment or death in patients treated with rituximab without chemotherapy.
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Affiliation(s)
- Henna-Riikka Junlén
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Lockmer
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Kimby
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Björn Engelbrekt Wahlin
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden. .,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden.
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8
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Kimby E, Lockmer S, Holte H, Hagberg H, Wahlin BE, Brown P, Østenstad B. The simplified follicular lymphoma PRIMA‐prognostic index is useful in patients with first‐line chemo‐free rituximab‐based therapy. Br J Haematol 2020; 191:738-747. [DOI: 10.1111/bjh.16692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 04/05/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Eva Kimby
- Unit of Hematology Department of Medicine at Huddinge Karolinska Institutet Stockholm Sweden
| | - Sandra Lockmer
- Unit of Hematology Department of Medicine at Huddinge Karolinska Institutet Stockholm Sweden
- Unit of Hematology Karolinska University Hospital Stockholm Sweden
| | - Harald Holte
- Department of Oncology Oslo University Hospital Oslo Norway
- KG Jebsen Center for B‐Cell Malignancies Oslo Norway
| | - Hans Hagberg
- Department of Oncology Academic Hospital Uppsala Sweden
| | - Björn E. Wahlin
- Unit of Hematology Department of Medicine at Huddinge Karolinska Institutet Stockholm Sweden
- Unit of Hematology Karolinska University Hospital Stockholm Sweden
| | - Peter Brown
- Department of Hematology Rigshospitalet Copenhagen Denmark
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9
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Lockmer S, Ren W, Brodtkorb M, Østenstad B, Wahlin BE, Pan-Hammarström Q, Kimby E. M7-FLIPI is not prognostic in follicular lymphoma patients with first-line rituximab chemo-free therapy. Br J Haematol 2019; 188:259-267. [PMID: 31423576 DOI: 10.1111/bjh.16159] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/22/2019] [Indexed: 11/29/2022]
Abstract
The clinical course of follicular lymphoma (FL) is highly variable. Recently the m7-FL international prognostic index (FLIPI) integrating performance status, FLIPI score and the mutational status of seven genes, was shown to stratify patients into "low-risk" and "high-risk" with respect to 5-year failure-free survival after first-line immunochemotherapy. Our aim was to evaluate the model after rituximab without chemotherapy. The Nordic Lymphoma Group performed two randomized clinical trials on indolent lymphoma patients receiving single rituximab and rituximab with interferon-α2a. In total, 95 FL patients had sufficient fresh-frozen diagnostic material for sequencing. A targeted panel for the genes EZH2, ARID1A, MEF2B, EP300, FOXO1, CREBBP and CARD11 was utilized for m7-FLIPI score calculation. With a median follow-up of 10·6 years, 76% of patients were alive. No difference in time to treatment failure (TTF), defined as the interval between start of trial therapy and initiation of new therapy or death, nor overall survival (OS) was found between the m7-FLIPI risk groups (log-rank P = 0·94 and 0·99, respectively). EZH2 mutations were associated with longer TTF (log-rank P = 0·04) and in EP300 mutations were associated with shorter TTF (log-rank P = 0·01). We conclude that the prognostic value of the m7-FLIPI clinicogenetic model seems dependent on therapeutic regimen.
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Affiliation(s)
- Sandra Lockmer
- Unit of Haematology, Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden
| | - Weicheng Ren
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | | | - Bjørn Østenstad
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Björn E Wahlin
- Unit of Haematology, Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden
| | | | - Eva Kimby
- Unit of Haematology, Department of Medicine at Huddinge, Karolinska Institutet, Stockholm, Sweden
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Lockmer S, Østenstad B, Hagberg H, Holte H, Wahlin BE, Wader KF, Smedby KE, Brown P, Kimby E. Reply to M. Sorigue et al. J Clin Oncol 2019; 37:759-760. [PMID: 30735430 DOI: 10.1200/jco.18.02362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sandra Lockmer
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Bjørn Østenstad
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Hans Hagberg
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Harald Holte
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Björn Engelbrekt Wahlin
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Karin Fahl Wader
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Karin Ekström Smedby
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Peter Brown
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
| | - Eva Kimby
- Sandra Lockmer, MD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Bjørn Østenstad, MD, PhD, Oslo University Hospital, Oslo, Norway; Hans Hagberg, MD, PhD, Academic Hospital, Uppsala, Sweden; Harald Holte, MD, PhD, Oslo University Hospital, Oslo, Norway; Björn Engelbrekt Wahlin, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Karin Fahl Wader, MD, PhD, St Olavs Hospital, Trondheim, Norway; Karin Ekström Smedby, MD, PhD, Karolinska Institutet, Stockholm, Sweden Karolinska University Hospital, Stockholm, Sweden; Peter Brown, MD, PhD, Rigshospitalet, Copenhagen, Denmark; and Eva Kimby, MD, PhD, Karolinska Institutet, Stockholm, Sweden
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Steen CB, Leich E, Myklebust JH, Lockmer S, Wise JF, Wahlin BE, Østenstad B, Liestøl K, Kimby E, Rosenwald A, Smeland EB, Holte H, Lingjærde OC, Brodtkorb M. A clinico-molecular predictor identifies follicular lymphoma patients at risk of early transformation after first-line immunotherapy. Haematologica 2019; 104:e460-e464. [PMID: 30846496 DOI: 10.3324/haematol.2018.209080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Chloé B Steen
- Department of Informatics, University of Oslo, Oslo, Norway.,Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Ellen Leich
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Centre Mainfranken, Germany
| | - June H Myklebust
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for B-Cell Malignancies, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sandra Lockmer
- Division of Haematology, Department of Medicine at Huddinge, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Jillian F Wise
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for B-Cell Malignancies, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Björn E Wahlin
- Division of Haematology, Department of Medicine at Huddinge, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Bjørn Østenstad
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Knut Liestøl
- Department of Informatics, University of Oslo, Oslo, Norway.,Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
| | - Eva Kimby
- Division of Haematology, Department of Medicine at Huddinge, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Centre Mainfranken, Germany
| | - Erlend B Smeland
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for B-Cell Malignancies, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Harald Holte
- KG Jebsen Centre for B-Cell Malignancies, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Ole Christian Lingjærde
- Department of Informatics, University of Oslo, Oslo, Norway .,KG Jebsen Centre for B-Cell Malignancies, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Marianne Brodtkorb
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway .,KG Jebsen Centre for B-Cell Malignancies, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway
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Lockmer S, Østenstad B, Hagberg H, Holte H, Johansson AS, Wahlin BE, Wader KF, Steen CB, Meyer P, Maisenhølder M, Smedby KE, Brown P, Kimby E. Chemotherapy-Free Initial Treatment of Advanced Indolent Lymphoma Has Durable Effect With Low Toxicity: Results From Two Nordic Lymphoma Group Trials With More Than 10 Years of Follow-Up. J Clin Oncol 2018; 36:JCO1800262. [PMID: 30285560 DOI: 10.1200/jco.18.00262] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
PURPOSE For indolent lymphoma, the optimal timing, sequence, and choice of therapeutic regimens remain a matter of debate. In two Nordic Lymphoma Group randomized trials, symptomatic or clearly progressing patients were treated first line with a rituximab-containing regimen without chemotherapy. The purpose of this study was to assess long-term survival, risk of transformation, and need of new therapies. METHODS Data were collected at cross-sectional follow-up for 321 patients with indolent lymphoma (84% with follicular lymphomas [FL]) included in one of two Nordic Lymphoma Group trials (accrual 1998 to 1999 and 2002 to 2008). All patients received first-line therapy with one or two cycles of four weekly infusions of rituximab 375 mg/m2, and 148 were randomly allocated to the addition of interferon alfa-2a. Follow-up data were retrieved from initial trial databases and medical records on repeated clinical evaluations. RESULTS At the end of follow-up, 73% of patients were alive, with a median follow-up after random assignment of 10.6 years. Among all, 36% (38% with FL) had never needed chemotherapy. For patients with FL who required new therapy within 24 months because of early disease progression, the 10-year survival rate was 59% versus 81% for those with longer remission. Interferon was not shown to improve long-term outcome. Transformation was diagnosed in 20% of all patients (2.4% per person-year) and in 18% with FL. An additional malignancy was found in 12%. CONCLUSION Approximately one third of patients with symptomatic indolent lymphoma (30% with FL, 23% without FL) did not need new therapy in the long term after first-line rituximab without chemotherapy. In the entire cohort, 10-year survival was excellent with no major safety issues, which suggests that chemotherapy can be delayed safely in the majority of patients.
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Affiliation(s)
- Sandra Lockmer
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Bjørn Østenstad
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Hans Hagberg
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Harald Holte
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Ann-Sofie Johansson
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Björn Engelbrekt Wahlin
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Karin Fahl Wader
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Chloé Beate Steen
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Peter Meyer
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Martin Maisenhølder
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Karin Ekström Smedby
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Peter Brown
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
| | - Eva Kimby
- Sandra Lockmer, Björn Engelbrekt Wahlin, Karin Ekström Smedby, and Eva Kimby, Karolinska Institutet; Sandra Lockmer, Björn Engelbrekt Wahlin, and Karin Ekström Smedby, Karolinska University Hospital, Stockholm; Hans Hagberg, Academic Hospital, Uppsala; Ann-Sofie Johansson, Norrlands University Hospital, Umeå, Sweden; Bjørn Østenstad and Harald Holte, Oslo University Hospital; Chloé Beate Steen, University of Oslo, Oslo; Karin Fahl Wader, St Olavs Hospital, Trondheim; Peter Meyer, Stavanger University Hospital, Stavanger; Martin Maisenhølder, University Hospital of Northern Norway, Tromsø, Norway; and Peter Brown, Rigshospitalet, Copenhagen, Denmark
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Federico M, Caballero D, Marcheselli L, Tarantino V, Sarkozy C, Lopez Guillermo A, Wondergem M, Kimby E, Rusconi C, Zucca E, Montoto S, da Silva M, Aurer I, Paszkiewicz-Kozik E, Cartron G, Morschhauser F, Alcoceba M, Chamuleau M, Lockmer S, Minoia C, Issa D, Alonso S, Conte L, Salles G, Coiffier B. THE RISK OF TRANSFORMATION OF FOLLICULAR LYMPHOMA “TRANSFORMED” BY RITUXIMAB: THE ARISTOTLE STUDY PROMOTED BY THE EUROPEAN LYMPHOMA INSTITUTE. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M. Federico
- Department of Diagnostic, Clinical and Public Health Medicine; University of Modena e Reggio Emilia; Modena Italy
| | - D. Caballero
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - L. Marcheselli
- Department of Diagnostic, Clinical and Public Health Medicine; University of Modena e Reggio Emilia; Modena Italy
| | - V. Tarantino
- Department of Diagnostic, Clinical and Public Health Medicine; University of Modena e Reggio Emilia; Modena Italy
| | - C. Sarkozy
- Department of Hematology, Hospices Civils de Lyon; Universite Claude Bernard Lyon-1Pierre Bénite Cedex; France
| | - A. Lopez Guillermo
- Department of Hematology; Hospital Clinic, IDIBAPS, CIBERONC; Barcelona Spain
| | - M. Wondergem
- Department of Hematology; VU University Medical Center; Amsterdam Netherlands
| | - E. Kimby
- Department of Hematology; Karolinska Institute; Stockholm Sweden
| | - C. Rusconi
- Division of Hematology; Niguarda Hospital; Milan Italy
| | - E. Zucca
- Oncology Institute of Southern Switzerland; Ospedale San Giovanni; Bellinzona Switzerland
| | - S. Montoto
- Department of Hematology; Barts Cancer Institute, QMUL; London UK
| | - M.G. da Silva
- Department of Hematology; Instituto Português de Oncologia de Lisboa; Lisbon Portugal
| | - I. Aurer
- Division of Hematology; University Hospital Centre Zagreb; Zagreb Croatia
| | - E. Paszkiewicz-Kozik
- Department of Lymphoid Malignancies; The Maria Sklodowska-Curie Memorial Institute and Oncology Centre; Warszawa Poland
| | - G. Cartron
- Department of Hematology; CHU Montpellier; Montpellier France
| | - F. Morschhauser
- Department of Clinical Hematology, CHU Lille, Unite GRITA; Universite de Lille 2; Lille France
| | - M. Alcoceba
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - M. Chamuleau
- Department of Hematology; VU University Medical Center; Amsterdam Netherlands
| | - S. Lockmer
- Department of Hematology; Karolinska Institute; Stockholm Sweden
| | - C. Minoia
- Haematology Unit, National Cancer Research Centre; Istituto Tumori "Giovanni Paolo II"; Bari Italy
| | - D. Issa
- Department of Hematology, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch; Netherlands
| | - S. Alonso
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - L. Conte
- Interdisciplinary Laboratory of Applied Research in Medicine (DReAM); University of Salento; Lecce Italy
| | - G. Salles
- Department of Hematology, Hospices Civils de Lyon; Universite Claude Bernard Lyon-1Pierre Bénite Cedex; France
| | - B. Coiffier
- Department of Hematology, Hospices Civils de Lyon; Universite Claude Bernard Lyon-1Pierre Bénite Cedex; France
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