Clinical risk factors for transformation reported in studies from the last 2 decades
| Reference . | No. of patients . | Incidence TFL . | Median survival after transformation, y . | PS 2-4 . | Stage III-IV . | Hgb low . | LDH high . | FLIPI . | Treatment . | Effect of treatment . |
|---|---|---|---|---|---|---|---|---|---|---|
| 10 | 220 | 31% at 10 y | 0.6 | NS | NS | NR | NS | NR | Chemo | NR |
| 38 | 276 | 15% at 10 y | 1.2 | NR | NR | NR | Sig | Sig | Observation, chemo | No effect |
| 11 | 325 | 28% at 10 y | 1.2 | NR | Sig | NR | NR | Sig | Observation, radiation, chemo | Observation: increased risk |
| 12 | 600 | 30% at 10 y | 1.7 | NS | Sig | NS | NS | NS | BP-VACOP-RT, alkylator and purine analog | • Observation: no effect |
| • Alkylator with purine analog: increased risk | ||||||||||
| 39 | 281 | 15% at 10 y | 2.7 | NS | NS | NS | NS | NS | Observation, chemo, R, R-chemo | • R-chemo: increased risk |
| • R-monotherapy: reduced risk | ||||||||||
| • Chemo, observation: intermediate risk | ||||||||||
| 13 | 631 | 10.7% at 5 y | 4.2 | NS | NS | Sig | Sig | Sig | Observation, chemo, R, R-chemo | • Observation: increased risk |
| • R-monotherapy: reduced risk | ||||||||||
| 17 | 126 | NA | 3.9 | NS | NS | NS | Sig | NS | Observed, R or R-chemo | NR |
| 14 | 2652 | 14.3% at 6.8 y | 5.0 | Sig | NS | NS | Sig | NR | Observed, R, R-chemo, other | • Observation: increased risk |
| • R-CHOP vs R-CVP: no effect | ||||||||||
| 15 | 1018 | NA | 3.8 | Sig | NS | Sig | Sig | Sig | R-chemo ± R-maintenance | • R-maintenance: no effect |
| • R-CHOP vs R-CVP vs R-FCM: no effect (but small numbers) |
| Reference . | No. of patients . | Incidence TFL . | Median survival after transformation, y . | PS 2-4 . | Stage III-IV . | Hgb low . | LDH high . | FLIPI . | Treatment . | Effect of treatment . |
|---|---|---|---|---|---|---|---|---|---|---|
| 10 | 220 | 31% at 10 y | 0.6 | NS | NS | NR | NS | NR | Chemo | NR |
| 38 | 276 | 15% at 10 y | 1.2 | NR | NR | NR | Sig | Sig | Observation, chemo | No effect |
| 11 | 325 | 28% at 10 y | 1.2 | NR | Sig | NR | NR | Sig | Observation, radiation, chemo | Observation: increased risk |
| 12 | 600 | 30% at 10 y | 1.7 | NS | Sig | NS | NS | NS | BP-VACOP-RT, alkylator and purine analog | • Observation: no effect |
| • Alkylator with purine analog: increased risk | ||||||||||
| 39 | 281 | 15% at 10 y | 2.7 | NS | NS | NS | NS | NS | Observation, chemo, R, R-chemo | • R-chemo: increased risk |
| • R-monotherapy: reduced risk | ||||||||||
| • Chemo, observation: intermediate risk | ||||||||||
| 13 | 631 | 10.7% at 5 y | 4.2 | NS | NS | Sig | Sig | Sig | Observation, chemo, R, R-chemo | • Observation: increased risk |
| • R-monotherapy: reduced risk | ||||||||||
| 17 | 126 | NA | 3.9 | NS | NS | NS | Sig | NS | Observed, R or R-chemo | NR |
| 14 | 2652 | 14.3% at 6.8 y | 5.0 | Sig | NS | NS | Sig | NR | Observed, R, R-chemo, other | • Observation: increased risk |
| • R-CHOP vs R-CVP: no effect | ||||||||||
| 15 | 1018 | NA | 3.8 | Sig | NS | Sig | Sig | Sig | R-chemo ± R-maintenance | • R-maintenance: no effect |
| • R-CHOP vs R-CVP vs R-FCM: no effect (but small numbers) |
BP-VACOP-RT, bleomycin, cisplatin, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, radiation; Chemo, chemotherapy; Hgb, hemoglobin; NA, not applicable; NR, not reported; NS, not statistically significant; PS, performance status; R, rituximab; R-FCM, rituximab with fludarabine, cyclophosphamide, and mitoxantrone; Sig, statistically significant.