ASCO: Transformation

Another abstract from the ASCO conference to be held in a couple of weeks.

This one is called "Transformation of follicular lymphoma in the era of immunochemotherapy: A population-based study from British Columbia."


 There was some encouraging news from it (though, of course with the usual "yeah, but..."). The study aimed to find out whether Rituxan, which has had such a positive impact on fNHL in general, has had any impact on transformation -- when Follicular turns into a more aggressive form of lymphoma.

As the abstract notes, most studies put transformation risk at about 3%. In other words, about 3% of Follicular patients will transform every year, and about 15-20% will transform over 5 years. (This abstract doesn't say it, but depending on who you ask, the risk is anywhere from 30-50% over 15 years, and the risk seems to disappear after that time.) The researchers looked at 261 patients with Follicular NHL from the Lymphoid Cancer Database of the British Columbia Cancer Agency. All had been treated with either CVP + Rituxan or Fludarabine + Rituxan. Some also received Rituxan Maintenance (infusions of Rituxan every 6 months after the initial treatment).

According to the study, the risk of transformation for the entire group was 2% per year -- lower than the 3% from other studies. This suggests that Immunochemotherapy (that is, combining chemo and Rituxan) lowers the risk of transformation.

The study also found, though, that the rate of transformation for patients who received R-Maintenance was  even lower: about 1.5% per year.

They seem careful not to make too many promises in their abstract. It's a relatively small study of a very geographically limited population. (I have no idea if geography, or environment, has anything to do with transformation, but it seems like a broader study would be more trustworthy.) But it's significant enough to justify further exploration. Some kind of relief for transformation would certainly make Follicular patients happy.