Despite improvements in the treatment for follicular lymphoma, including the introduction of anti-CD20 therapies like rituximab, the leading cause of death remains lymphoma, according to a recent analysis.
Researchers led by Clementine Sarkozy, MD, of the University of Lyon (France), analyzed the cause of death for 1,654 follicular lymphoma patients across one French and one U.S. cohort. The French cohort enrolled patients between 2001 and 2013 and the U.S. cohort enrolled patients between 2002 and 2012.
Among the 734 patients in the French cohort, there were 113 deaths after a median 89 months follow-up. Similarly, following a median follow-up of 84 months, there were 170 deaths among the 920 U.S. patients. The 10-year overall survival was similar in the two cohorts at 79.8% among the French patients and 76.6% among the U.S. patients, the researchers reported in the Journal of Clinical Oncology.
Cause of death information was available for 283 patients across the two cohorts. In 140 patients (56.5%), the cause of death was lymphoma; more than half of those cases occurred in patients whose disease had transformed at some point. That puts the cumulative risk of mortality from lymphoma at 10.3% at 10 years, according to the researchers.
The researchers also noted that the Follicular Lymphoma International Prognostic Index score was strongly linked to lymphoma-related mortality but not to nonlymphoma causes of death.
Another 42 patients (17%) died from treatment-related causes, mainly infection. About 13% of the cohort died from other cancers and another 13% died from other causes.
“Deaths related to treatment seem to also be a significant burden and new, less-toxic treatment options need to be investigated,” the researchers wrote.
The study was supported by the National Institutes of Health. Dr. Sarkozy reported financial relationships with Genentech, Celgene, and Takeda.
SOURCE: Sarkozy C et al. J Clin Oncol. 2019 Jan 10;37(2):144-52.