175376397ff4883d907f2bbaf51b9fdc 302155.pdf 875b0a47cf21b1bcf6fe27e07fa945a588cfd8a6 302155.pdf 4d0aa3cad68f717e6e79d092f50091f6ad8203ed42eff0f8a4283ba3d80c0840 302155.pdf Title: Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study Subject: Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and R-bendamustine (R-B) are the most common frontline treatment strategies for advanced-stage follicular lymphoma (FL). After R-CHOP induction therapy, using rituximab for maintenance therapy notably improves outcomes; however, whether this can be achieved by using the same approach after R-B therapy is still being determined. This retrospective analysis compared 476 FL patients from 17 GELTAMO centers who received R-based regimens followed by rituximab maintenance therapy for untreated advanced-stage FL. The complete response rate at the end of induction was higher with R-B and relapses were more frequent with R-CHOP. During induction, cytopenias were significantly more frequent with R-CHOP and so was the use of colony-stimulating factors. During maintenance therapy, R-B showed more neutropenia and infectious toxicity. After a median follow-up of 81 months (95% CI: 77–86), the 6-year rates of progression-free survival (PFS) were 79% (95% CI: 72–86) for R-bendamustine vs. 67% (95% CI: 61–73) for R-CHOP (p = 0.046), and 6-year overall survival (OS) values were 91% (95% CI: 86–96) for R-B vs. 91% (95% CI: 87–94) for R-CHOP (p = 0.49). In conclusion, R-B followed by rituximab maintenance therapy in patients with previously untreated FL resulted in significantly longer PFS than R-CHOP, with older patients also benefiting from this treatment without further toxicity. Adverse events during maintenance were more frequent with R-B without impacting mortality. Keywords: follicular lymphoma; rituximab; R-bendamustine; R-CHOP; maintenance Author: Mariana Bastos-Oreiro, Antonio Gutierrez, Almudena Cabero, Javier López, Paola Villafuerte, Ana Jiménez-Ubieto, Raquel de Oña, Adolfo De la Fuente, Belén Navarro, Javier Peñalver, Pilar Martínez, Carmen Alonso, María Infante, Raúl Córdoba, Blanca Perez-Montero, Jaime Pérez de Oteyza, Sonia González de Villambrosio, Paula Fernández-Caldas, Raquel del Campo, Daniel García Belmonte, Javier Diaz-Gálvez, Antonio Salar and Juan-Manuel Sancho Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Mar 26 12:53:05 2024 CET ModDate: Tue Mar 26 12:55:41 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 484139 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- DGBDNV+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 BJLKQH+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 FOESIT+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 YDKCVC+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 OPZDHV+VnURWPalladioL Type 1 Custom yes yes yes 32 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 49 0 MEPKLC+CMSY10 Type 1 Builtin yes yes yes 69 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 77 0 KGNHAA+Arial CID TrueType Identity-H yes yes yes 102 0 KGNEOF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 108 0 KGNEOH+PalatinoLinotype TrueType WinAnsi yes yes no 111 0 KGNEPJ+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 114 0 KGNGPA+Calibri CID TrueType Identity-H yes yes yes 117 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-12-20 02:48:10 CET RepresentationInformation: 302155.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-12-19 09:43:15 CET Size: 484139 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 253 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Material and Methods Destination: section.2 Children: Item: Title: Patients Destination: subsection.2.1 Item: Title: Statistical Analysis Destination: subsection.2.2 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Comparing R-Bendamustine vs. R-CHOP Plus Maintenance Therapy as First-Line Systemic Treatment in Follicular Lymphoma: A Multicenter Retrospective GELTAMO Study Author: Mariana Bastos-Oreiro, Antonio Gutierrez, Almudena Cabero, Javier López, Paola Villafuerte, Ana Jiménez-Ubieto, Raquel de Oña, Adolfo De la Fuente, Belén Navarro, Javier Peñalver, Pilar Martínez, Carmen Alonso, María Infante, Raúl Córdoba, Blanca Perez-Montero, Jaime Pérez de Oteyza, Sonia González de Villambrosio, Paula Fernández-Caldas, Raquel del Campo, Daniel García Belmonte, Javier Diaz-Gálvez, Antonio Salar and Juan-Manuel Sancho Subject: Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and R-bendamustine (R-B) are the most common frontline treatment strategies for advanced-stage follicular lymphoma (FL). After R-CHOP induction therapy, using rituximab for maintenance therapy notably improves outcomes; however, whether this can be achieved by using the same approach after R-B therapy is still being determined. This retrospective analysis compared 476 FL patients from 17 GELTAMO centers who received R-based regimens followed by rituximab maintenance therapy for untreated advanced-stage FL. The complete response rate at the end of induction was higher with R-B and relapses were more frequent with R-CHOP. During induction, cytopenias were significantly more frequent with R-CHOP and so was the use of colony-stimulating factors. During maintenance therapy, R-B showed more neutropenia and infectious toxicity. After a median follow-up of 81 months (95% CI: 77 86), the 6-year rates of progression-free survival (PFS) were 79% (95% CI: 72 86) for R-bendamustine vs. 67% (95% CI: 61 73) for R-CHOP (p = 0.046), and 6-year overall survival (OS) values were 91% (95% CI: 86 96) for R-B vs. 91% (95% CI: 87 94) for R-CHOP (p = 0.49). In conclusion, R-B followed by rituximab maintenance therapy in patients with previously untreated FL resulted in significantly longer PFS than R-CHOP, with older patients also benefiting from this treatment without further toxicity. Adverse events during maintenance were more frequent with R-B without impacting mortality. Keywords: follicular lymphoma; rituximab; R-bendamustine; R-CHOP; maintenance Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Mar 26 12:53:05 CET 2024 ModDate: Tue Mar 26 12:55:41 CET 2024 ID: 0x37ade8678cdc098d2649dada7c2bd02c, 0x37ade8678cdc098d2649dada7c2bd02c Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: BJLKQH+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 241 FontDescriptor: FontName: BJLKQH+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: OPZDHV+VnURWPalladioL FontSubset: true FirstChar: 161 LastChar: 226 FontDescriptor: FontName: OPZDHV+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: MEPKLC+CMSY10 FontSubset: true FirstChar: 1 LastChar: 20 FontDescriptor: FontName: MEPKLC+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true ToUnicode: true Font: BaseFont: FOESIT+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: FOESIT+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: DGBDNV+VnURWPalladioL-Bold FontSubset: true FirstChar: 161 LastChar: 243 FontDescriptor: FontName: DGBDNV+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: YDKCVC+URWPalladioL-Ital FontSubset: true FirstChar: 46 LastChar: 121 FontDescriptor: FontName: YDKCVC+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: WBVKDJ+URWPalladioL-BoldItal FontSubset: true FirstChar: 112 LastChar: 112 FontDescriptor: FontName: WBVKDJ+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 106, 279, 152, 288 Annotation: Subtype: Link Rect: 34, 267, 140, 276 Annotation: Subtype: Link Rect: 34, 164, 96, 186 Annotation: Subtype: Link Rect: 125, 90, 154, 99 Annotation: Subtype: Link Rect: 34, 78, 149, 87 Annotation: Subtype: Link Rect: 34, 756, 152, 792 Annotation: Subtype: Link Rect: 515, 756, 560, 792 Annotation: Subtype: Link Rect: 260, 642, 271, 655 Annotation: Subtype: Link Rect: 194, 616, 205, 630 Annotation: Subtype: Link Rect: 282, 616, 293, 630 Annotation: Subtype: Link Rect: 407, 616, 418, 630 Annotation: Subtype: Link Rect: 539, 604, 550, 617 Annotation: Subtype: Link Rect: 216, 592, 227, 605 Annotation: Subtype: Link Rect: 361, 592, 372, 605 Annotation: Subtype: Link Rect: 114, 17, 265, 28 Annotation: Subtype: Link Rect: 410, 17, 560, 28 Annotation: Subtype: Link Rect: 34, 400, 87, 419 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 538, 445, 545, 454 ActionDest: 132 Annotation: Subtype: Link Rect: 548, 445, 555, 454 ActionDest: 132 Annotation: Subtype: Link Rect: 487, 420, 494, 429 ActionDest: 132 Annotation: Subtype: Link Rect: 350, 382, 357, 392 ActionDest: 132 Annotation: Subtype: Link Rect: 219, 370, 226, 379 ActionDest: 132 Annotation: Subtype: Link Rect: 487, 345, 494, 354 ActionDest: 132 Annotation: Subtype: Link Rect: 494, 345, 501, 354 ActionDest: 132 Annotation: Subtype: Link Rect: 411, 307, 418, 316 ActionDest: 132 Annotation: Subtype: Link Rect: 419, 307, 431, 316 ActionDest: 132 Annotation: Subtype: Link Rect: 343, 270, 355, 279 ActionDest: 135 Annotation: Subtype: Link Rect: 358, 269, 370, 279 ActionDest: 135 Annotation: Subtype: Link Rect: 349, 257, 361, 266 ActionDest: 135 Annotation: Subtype: Link Rect: 361, 257, 373, 266 ActionDest: 135 Annotation: Subtype: Link Rect: 393, 207, 405, 216 ActionDest: 135 Annotation: Subtype: Link Rect: 529, 169, 541, 178 ActionDest: 135 Annotation: Subtype: Link Rect: 544, 169, 556, 178 ActionDest: 135 Annotation: Subtype: Link Rect: 294, 119, 306, 128 ActionDest: 135 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 261, 476, 273, 485 ActionDest: 132 Annotation: Subtype: Link Rect: 373, 184, 380, 196 ActionDest: 74 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 245, 138, 252, 150 ActionDest: 82 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 441, 419, 448, 431 ActionDest: 85 Annotation: Subtype: Link Rect: 469, 419, 476, 431 ActionDest: 88 Annotation: Subtype: Link Rect: 195, 406, 202, 418 ActionDest: 85 Annotation: Subtype: Link Rect: 452, 356, 459, 368 ActionDest: 88 Annotation: Subtype: Link Rect: 229, 343, 236, 355 ActionDest: 88 Page: Sequence: 6 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 199, 367, 206, 379 ActionDest: 88 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 356, 741, 363, 753 ActionDest: 126 Annotation: Subtype: Link Rect: 444, 371, 456, 380 ActionDest: 135 Annotation: Subtype: Link Rect: 499, 371, 511, 380 ActionDest: 135 Annotation: Subtype: Link Rect: 512, 371, 524, 380 ActionDest: 135 Annotation: Subtype: Link Rect: 531, 296, 543, 305 ActionDest: 135 Annotation: Subtype: Link Rect: 544, 296, 556, 305 ActionDest: 135 Annotation: Subtype: Link Rect: 260, 258, 272, 267 ActionDest: 135 Annotation: Subtype: Link Rect: 184, 233, 196, 242 ActionDest: 135 Annotation: Subtype: Link Rect: 331, 170, 343, 179 ActionDest: 135 Annotation: Subtype: Link Rect: 540, 70, 552, 79 ActionDest: 135 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 289, 706, 301, 715 ActionDest: 135 Annotation: Subtype: Link Rect: 513, 668, 525, 677 ActionDest: 135 Annotation: Subtype: Link Rect: 259, 630, 271, 639 ActionDest: 135 Annotation: Subtype: Link Rect: 467, 518, 479, 526 ActionDest: 135 Annotation: Subtype: Link Rect: 479, 518, 491, 526 ActionDest: 135 Annotation: Subtype: Link Rect: 479, 492, 491, 501 ActionDest: 135 Annotation: Subtype: Link Rect: 531, 455, 543, 464 ActionDest: 135 Annotation: Subtype: Link Rect: 544, 455, 556, 464 ActionDest: 135 Annotation: Subtype: Link Rect: 531, 342, 543, 351 ActionDest: 135 Annotation: Subtype: Link Rect: 544, 342, 556, 351 ActionDest: 135 Annotation: Subtype: Link Rect: 254, 153, 266, 162 ActionDest: 139 Annotation: Subtype: Link Rect: 267, 153, 279, 162 ActionDest: 139 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 505, 692, 560, 703 Annotation: Subtype: Link Rect: 165, 680, 343, 691 Annotation: Subtype: Link Rect: 300, 407, 338, 418 Annotation: Subtype: Link Rect: 59, 374, 96, 384 Annotation: Subtype: Link Rect: 270, 338, 307, 349 Annotation: Subtype: Link Rect: 284, 305, 321, 315 Annotation: Subtype: Link Rect: 118, 259, 155, 269 Annotation: Subtype: Link Rect: 167, 224, 204, 234 Annotation: Subtype: Link Rect: 381, 200, 418, 211 Annotation: Subtype: Link Rect: 140, 155, 177, 165 Annotation: Subtype: Link Rect: 96, 121, 134, 131 Annotation: Subtype: Link Rect: 196, 74, 233, 85 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 520, 660, 557, 671 Annotation: Subtype: Link Rect: 104, 627, 141, 637 Annotation: Subtype: Link Rect: 59, 581, 96, 591 Annotation: Subtype: Link Rect: 483, 557, 520, 568 Annotation: Subtype: Link Rect: 429, 522, 467, 533 Annotation: Subtype: Link Rect: 311, 488, 349, 499 Annotation: Subtype: Link Rect: 487, 453, 524, 464 Annotation: Subtype: Link Rect: 519, 419, 557, 430 Annotation: Subtype: Link Rect: 112, 385, 149, 395 Annotation: Subtype: Link Rect: 196, 350, 233, 361 Annotation: Subtype: Link Rect: 476, 315, 513, 326 Annotation: Subtype: Link Rect: 306, 281, 344, 292 Annotation: Subtype: Link Rect: 295, 246, 332, 257 Annotation: Subtype: Link Rect: 108, 201, 146, 211 Annotation: Subtype: Link Rect: 405, 189, 442, 200 Annotation: Subtype: Link Rect: 453, 166, 490, 177 Annotation: Subtype: Link Rect: 519, 131, 557, 142 Annotation: Subtype: Link Rect: 259, 97, 297, 108 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 255, 718, 292, 729 Annotation: Subtype: Link Rect: 223, 673, 261, 683 Annotation: Subtype: Link Rect: 267, 673, 303, 683 Checksum: fc3d57ff Type: CRC32 Checksum: 175376397ff4883d907f2bbaf51b9fdc Type: MD5 Checksum: 875b0a47cf21b1bcf6fe27e07fa945a588cfd8a6 Type: SHA-1 Checksum: 4d0aa3cad68f717e6e79d092f50091f6ad8203ed42eff0f8a4283ba3d80c0840 Type: SHA-256