Patients with follicular lymphoma who have been treated and are in remission for at least 2 years may no longer be incurable based on highly sensitive testing. This may mean they no longer need therapy or active follow-up, according to findings presented by Sarraf Yazdy et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 2183).
“While follicular lymphoma is not one of the more aggressive types of cancer we treat, the majority of patients continue to experience disease recurrence over many years and have to receive different types of therapy,” said Maryam Sarraf Yazdy, MD, a hematologist/oncologist at MedStar Georgetown University Hospital and Georgetown Lombardi Comprehensive Cancer Center. “This disease has been considered incurable, but for some patients who have been disease-free for at least 2 years after remission, our pilot study gives hope that calling the disease incurable may no longer be accurate.”
Methods
The study enrolled 68 patients with follicular lymphoma at a single center. They had all undergone conventional treatments for their disease and had been in clinical remission for over 2 years. Twenty-five patients had biopsy samples that did not meet the study criteria; therefore, only 43 patient samples were able to be fully assessed.
“This disease has been considered incurable, but for some patients who have been disease-free for at least 2 years after remission, our pilot study gives hope that calling the disease incurable may no longer be accurate.”— Maryam Sarraf Yazdy, MD
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First, patients’ biopsy samples from the time of their initial diagnoses were examined for changes in their lymphoma cells with next-generation sequencing tests. Next, a current sample of each patient's blood was evaluated to detect possible remaining lymphoma cells by searching for the specific genetic changes that were identified in the original biopsy samples.
Results
Upon analysis of 43 patients with next-generation sequencing, 38 of them did not show any evidence of lymphoma in their blood. The ability to detect which patients might be disease-free and might not need treatment anymore is important because many of these patients had undergone numerous therapies—often due to multiple relapses—and were always concerned about the possibility of their disease relapsing.
“More important than anything perhaps, is the lifting of the psychological burden these patients faced with a diagnosis of a presumed incurable disease,” concluded Dr. Sarraf Yazdy. “This is a pilot study in a small number of patients with a short follow-up time. We need to do more work, study a larger number of patients, and monitor them for a longer time—but this is an important first step.”
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
