Watch-and-wait OK in low-tumor burden follicular lymphoma

(HealthDay)—An initial watch-and-wait strategy does not have a detrimental effect on the freedom from treatment failure (FFTF) or overall survival rate in selected patients with low-tumor burden follicular lymphoma compared with patients initially treated with rituximab-containing regimens, according to research published online Sept. 24 in the Journal of Clinical Oncology.

Philippe Solal-Céligny, M.D., Ph.D., of the Institut de Cancérologie de l'Ouest in Saint Herblain, France, and colleagues conducted a prospective cohort study involving 120 patients with treatment-naive follicular lymphoma who were initially managed expectantly and 107 comparator patients. The majority of patients (80 percent) had a low tumor burden and disseminated disease.

Treatment was initiated in half of the patients after a median follow-up period of 64 months. After adjusting for potential confounders, the researchers found that patients with more than four nodal areas affected were 2.32-fold more likely to have a shorter time to lymphoma treatment initiation. Overall, watch-and-wait patients had a four-year FFTF rate of 79 percent, compared with 69 percent for those who were initially treated with a rituximab-containing regimen.

"Our data in a prospective and well-analyzed database that reflects actual practice suggest that there is no difference in outcome between patients who were observed and patients who were treated initially," the authors write. "Our cohort study provides additional information relevant to the important issue of management of patients with follicular lymphoma in the current era and suggests that observation remains an appropriate approach in asymptomatic patients with low-tumor burden follicular lymphoma."

Several authors disclosed financial ties to the pharmaceutical industry.

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