Title |
Prognostic value of circulating Bcl-2/IgH levels in patients with follicular lymphoma receiving first-line immunochemotherapy
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Published in |
Blood, August 2015
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DOI | 10.1182/blood-2015-03-630012 |
Pubmed ID | |
Authors |
Fabian Zohren, Ingmar Bruns, Sabrina Pechtel, Thomas Schroeder, Roland Fenk, Akos Czibere, Georg Maschmeyer, Dorothea Kofahl-Krause, Norbert Niederle, Gerhard Heil, Christoph Losem, Manfred Welslau, Wolfram Brugger, Ulrich Germing, Ralf Kronenwett, Juergen Barth, Mathias J Rummel, Rainer Haas, Guido Kobbe |
Abstract |
Bcl-2/IgH-rearrangements can be quantified in follicular lymphoma (FL) from peripheral blood (PB) by PCR. The prognostic value of Bcl-2/IgH levels in FL remains controversial. We therefore prospectively studied PB Bcl-2/IgH levels from 173 first-line FL patients who were consecutively enrolled, randomized and treated within the multicenter phase 3 clinical trial NHL1-2003 comparing bendamustine-rituximab (B-R) with CHOP-rituximab (R-CHOP). From April 2005 to August 2008 783 pre- and post- treatment PB samples were quantified by qPCR. At inclusion 114 patients (66%) tested positive and 59 (34%) were negative for Bcl-2/IgH. High pre-treatment Bcl-2/IgH levels had an adverse effect on PFS compared to intermediate or low levels (high vs. intermediate: HR 4.28, 95% CI 1.70 - 10.77; p=0.002; high vs. low: HR 3.02, 95% CI 1.55 - 5.86; p=0.001). No PFS difference between treatment arms was observed in Bcl-2/IgH-positive patients. A positive post-treatment Bcl-2/IgH status was associated with shorter PFS (8.7 months vs. not reached; HR 3.15, 95% CI 1.51-6.58; p=0.002). By multivariate analysis, the pre-treatment Bcl-2/IgH level was the strongest predictor for PFS. Our data suggest that pre- and post- treatment Bcl-2/IgH levels from PB have significant prognostic value for PFS in FL receiving first-line immuno-chemotherapy. This trial was registered to www.clinicaltrials.gov as #NCT00991211 and the German Federal Institute for Drugs and Medical Devices as #BfArM-4021335. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 2 | 50% |
Denmark | 1 | 25% |
Mexico | 1 | 25% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 3 | 75% |
Practitioners (doctors, other healthcare professionals) | 1 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Netherlands | 1 | 2% |
Unknown | 64 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 10 | 15% |
Other | 9 | 14% |
Student > Ph. D. Student | 7 | 11% |
Student > Bachelor | 5 | 8% |
Student > Master | 5 | 8% |
Other | 12 | 18% |
Unknown | 17 | 26% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 30 | 46% |
Agricultural and Biological Sciences | 4 | 6% |
Biochemistry, Genetics and Molecular Biology | 3 | 5% |
Nursing and Health Professions | 3 | 5% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Other | 4 | 6% |
Unknown | 20 | 31% |