Fludarabine in the treatment of follicular non-Hodgkin lymphoma

Authors

Abstract

Background: follicular non-Hodgkin's lymphoma occupies the second place among non-Hodgkin's lymphomas of line B, they are characterized by a pattern of continuous remissions and relapses. Fludarabine constitutes a treatment option for the same as it achieves a rapid remission, with a decrease in the percentage of relapse.
Objective:
to evaluate fludarabine as a rescue treatment for follicular non-Hodgkin lymphoma.
Methods:
a concurrent prospective longitudinal, analytical, observational cohort study was conducted. The study universe was made up of patients who attended the Hematology consultation with a diagnosis of follicular non-Hodgkin's lymphoma and consisted of 63 patients, of which 21 were selected by intentional non-probabilistic sampling who received treatment with fludarabine, made up a cohort of exposed, these were compared with 42 patients with similar characteristics who received other poly-chemotherapy regimens that did not include fludarabine and they constituted the unexposed cohort.
Results:
the number of male patients over 50 years of age, belonging to Cotswold stage IV, and those with a low-intermediate risk of relapse was greater. The disease-free survival time was longer in those treated with fludarabine, who had fewer complications.
Conclusions: in patients treated with fludarabine as rescue treatment for follicular lymphoma, the disease-free survival time was longer and there were fewer complications, which show its usefulness as a first-line treatment in the absence of rituximab.

DeCS: LYMPHOMA, NON-HODGKIN/drug therapy; LYMPHOMA, NON-HODGKIN/therapy; LYMPHOMA, FOLLICULAR/diagnosis; RECURRENCE; OBSERVATIONAL STUDY.

Downloads

Download data is not yet available.

Author Biography

Yaimé Moreno-Laguarda, Universidad de Ciecias Médicas de Camaüey

Profesora del CENIPBI

References

1. Moreno Laguarda Y, Laguna Salvia L, Larquin Comet JI, León Ramentol CC, Hernandez Soler YF, González Basulto MJ. Criterios diagnósticos y nuevas opciones terapéuticas para los pacientes con diagnóstico de Linfoma no Hodgkin. Arch méd Camagüey [Internet]. 2019 [citado 02 Nov 2020];23(3):415-426. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552019000300415&lng=es

2. Freedman AS, Jacobson CA, Mauch P, Aster JC. Non-Hodgkin’s lymphoma. En: De Vita VT, Lawrence TS, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology. 10 th ed. Philadelphia: Lippincott Williams&Wilkins; 2015. p. 1552-1583.

3. Skrabek P, Turner D, Seftel M. Epidemiology of nonhodgkin lymphoma. Transfus Apher Sci 2013; 49:133-138.

4. Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticos de Salud. Anuario estadístico de salud 2018 [Internet]. La Habana: MINSAP; 2019 [citado 02 Nov 2020]:[aprox. 193 p.]. Disponible en: https://files.sld.cu/bvscuba/files/2019/04/Anuario-Electr%C3%B3nico-Espa%C3%B1ol-2018-ed-2019-compressed.pdf

5. Costa LJ, Maddocks K, Epperla N, Reddy NM, Karmali R, Umyarova E, et al. Diffuse large B-cell lymphoma with primary treatment failure: Ultra-high risk features and benchmarking for experimental therapies. American journal of hematology. 2017;92:161-70.

6. Wagner-Johnston ND, Link BK, Byrtek M. Outcomes of transformed follicular lymphoma in the modern era: a report from the National Lympho Care Study (NLCS). Blood. 2015;126(7):851-7.

7. Alonso Mariño OL, Alonso Mariño AL, Miranda Chaviano J. Caracterización clínico-epidemiológica de los linfomas en un período de cinco años en Villa Clara. Medicent Electrón [Internet]. 2015 [citado 01 Abr 2019];19(1):[aprox. 6 p.]. Disponible en: http://www.medigraphic.com/pdfs/medicentro/cmc-2015/cmc151c.pdf

8. Grover N, Park S. Novel targeted agents in Hodgkin and non-Hodgkin lymphoma therapy. Pharmaceuticals (Basel, Switzerland). 2015;8(3):607-636.

9. Sorge CE, McDaniel JK, Xavier AC. Targeted Therapies for the Treatment of Non-Hodgkin Lymphomas: Present and Future. Pharmaceuticals. 2016;9(28):6-12.

10. Novoa JE, Beñaran B, Rojo AL, Cuña A, Iriondo N, Calvo H, et al. Monofosfato de fludarabina como primera línea en el tratamiento de los síndromes linfoproliferativos crónicos. Estudio multicéntrico, Uruguay 1997-2012. Rev Hematol. 2013;14(1):21-25.

11. Instituto Nacional de Cancerología. ESE-Guía de Práctica Clínica para la detección, tratamiento y seguimiento de linfoma Hodgkin y no Hodgkin en población mayor de 18 años [Internet]. Colombia: Ministerio de Salud y Protección Social; 2017 [citado 02 Nov 2020]. Disponible en: http://gpc.minsalud.gov.co/gpc_sites/Repositorio/Conv_563/GPC_Linfoma_Mayores_18A%C3%B1os/GPC_Linfoma.pdf

12. Gómez Gómez M, Danglot Banck C, Vega Franco L. Cómo seleccionar una prueba estadística. Rev Mex Pediatr. 2013; 80(2):81-85.

13. Campo E, Swerdlow SH, Harris NL. The 2008 WHO classification of lymphoid neoplasms and be-yond: evolving concepts and practical applications. Blood. 2011;117:5019-32.

14. Ning Jiang J, Hua Sun X. The prognosis factors research on the 172 non-hodgkin lymphoma cases. Biomedical Research. 2016;27(2):336-344.

15. Sacchi S, Pozzi S, Marcheselli R, Federico M, Tucci A, Merli F, et al. Rituximab in Combination With Fludarabine and Cyclophosphamide in the Treatment of Patients With Recurrent Follicular Lymphoma. Cancer 2007; 110:121–8.

16. Wang Y, Wu J, He W. The Jejunum Non-Hodgkin’s Diffuse Large B cell Lymphoma: an Origin of Extra-Germinal Center. Int J Cancer Cell Biol Res. 2017;1(1):001-005.

17. Sicras Mainar A, Castro A, Navarro Artieda R. Características clínicas y respuesta al tratamiento de pacientes adultos con leucemia linfática crónica (LLC) y linfoma no Hodgkin (LNH). Gac Med Mex. 2016;152:59-69.

18. Alonso Álvarez S. Caracterización clínica y biológica del proceso de transformación de los síndromes linfoproliferativos indolentes. Análisis histológico, fenotípico y molecular [Tesis]. Salamanca: Universidad de Salamanca; 2016 [citado 31 Oct 2019]. Disponible en:

https://gredos.usal.es/jspui/bitstream/10366/132943/1/DM_AlonsoAlvarezS_Caracterizacion.pdf

19. American Cancer Society. Non-Hodgkin Lymphoma Treatment. ACS. 2015;60(3):664-71.

20. Tse E, Kwong YL. Recent Advances in the Treatment of Lymphomas. J Hong Kong Col Radiol. 2010;13(Suppl):S22-4.

21. Foussard C, Colombat P, Deconinck E. Original article long-term follow-up of a randomized trial of fludarabine-mitoxantrone, compared with cyclophosphamide, doxorubicin, vindesine, prednisone (CHVP), as fi rst-line treatment of elderly patients with advanced, low-grade non-Hodgkin’s lymphoma before the era of monoclonal antibodies; on behalf of the Groupe Ouest-Est des Leucemies et Autres Maladies du Sang (GOELAMS). Ann Oncol. 2005; 16:466-72.

22. Zinzani PL, Pulsoni A, Perrotti A. Fludarabine plus mitoxantrone with and without rituximab versus CHOP with and without rituximab as front-line treatment for patients with follicular lymphoma. J Clin Oncol. 2004; 22:2654-61.

23. Labardini Méndez JR, Cervera Ceballos E, Corrales Alfaro C, Balbuena Martínez M, Barbosa Ibarra AA, Espinoza Zamora JR, et al. Oncoguía: Linfoma No Hodgkin. Cancerología 6. 2011:139-152.

24. Arcaini L, Merli M, Passamonti F. Validation of follicular lymphoma international prognostic index 2 (FLIPI2) score in an independent series of follicular lymphoma patients. Br J Haematol. 2010; 149(3):455-7.

25. Luminari S, Bellei M, Biasoli I, Federico M. Follicular lymphoma: treatment and prognostic factors. Rev Bras Hematol Hemoter [Internet]. 2012 [citado 31 Oct 2019];34(1):[aprox. 5 p.]. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842012000100015&lng=en

26. Redman JR, Cabanillas F, Velasques WS. Phase II trial of fludarabine phosphate in lymphoma: an effective agent in low grade lymphoma. JCO. 2012;10:790-794.

27. Cencini E, Fabbri A, Schiattone L, Bartalucci G, Bocchia M. Radiotherapy with rituximab as first-line treatment for early-stage follicular lymphoma. Leuk Lymphoma. 2015;56(10):2997-8.

28. Physician Data Query. Tratamiento del linfoma no Hodgkin en adultos [Internet]. Bethesda, MD: National Cancer Institute; 2016 [citado 6 Oct 2019]. Disponible en:

https://www.cancer.gov/espanol/tipos/linfoma/pro/tratamiento-lnh-adultos-pdq

Published

2020-12-02

How to Cite

1.
Moreno-Laguarda Y, Laguna-Salvia L, Larquin-Comet JI, León-Ramentol CC. Fludarabine in the treatment of follicular non-Hodgkin lymphoma. Arch méd Camagüey [Internet]. 2020 Dec. 2 [cited 2025 Oct. 12];24(6):856-67. Available from: https://revistaamc.sld.cu/index.php/amc/article/view/7654

Issue

Section

Original Articles