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Chemotherapy-Free I...
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
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- Lockmer, Sandra (författare)
- Karolinska Institutet
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- Ostenstad, Bjorn (författare)
- Oslo Univ Hosp, Oslo, Norway
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- Hagberg, Hans (författare)
- Uppsala universitet,Experimentell och klinisk onkologi
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- Holte, Harald (författare)
- Oslo Univ Hosp, Oslo, Norway
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- Johansson, Ann-Sofie (författare)
- Norrlands Univ Hosp, Umea, Sweden
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- Wahlin, Bjorn Engelbrekt (författare)
- Karolinska Institutet
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- Wader, Karin Fahl (författare)
- St Olavs Hosp, Trondheim, Norway
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- Steen, Chloe Beate (författare)
- Univ Oslo, Oslo, Norway
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- Meyer, Peter (författare)
- Stavanger Univ Hosp, Stavanger, Norway
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- Maisenholder, Martin (författare)
- Univ Hosp Northern Norway, Tromso, Norway
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- Smedby, Karin Ekstrom (författare)
- Karolinska Institutet
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- Brown, Peter (författare)
- Rigshosp, Copenhagen, Denmark
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- Kimby, Eva (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2018
- 2018
- Engelska.
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Ingår i: Journal of Clinical Oncology. - 0732-183X .- 1527-7755. ; 36:33, s. 3315-3323
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
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- 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/m(2), 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
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Lockmer, Sandra
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Ostenstad, Bjorn
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Hagberg, Hans
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Holte, Harald
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Johansson, Ann-S ...
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Wahlin, Bjorn En ...
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visa fler...
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Wader, Karin Fah ...
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Steen, Chloe Bea ...
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Meyer, Peter
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Maisenholder, Ma ...
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Smedby, Karin Ek ...
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Brown, Peter
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Kimby, Eva
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- MEDICIN OCH HÄLSOVETENSKAP
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Uppsala universitet
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Karolinska Institutet