Histological Impact on Follicular Lymphoma Grade 3 Treated With Frontline RCHOP Regimen

Abstract Background Histologically, follicular lymphoma (FL) grade 3 is subdivided into grade 3A and 3B. However, there are limited studies on outcomes of FL grade 3A and 3B treated with frontline of RCHOP treatment. Methods We retrospectively analyzed 61 patients of FL grade 3 treated with frontline RCHOP regimen between January 2009 and December 2019. We divided them into FL grade 3A (n = 42) and aggressive FL (n = 19). Aggressive FL included grade 3A with an additional 3B component (n = 2), grade 3B (n = 8), and grade 3 with areas of diffuse large B cell lymphoma (n = 9). Results The baseline characteristics were similar between FL grade 3A and aggressive FL. The 3-year overall survival (OS) was 97.1% in FL grade 3A and 81.9% in aggressive FL (P = 0.041). The 3-year progression free survival (PFS) was not significantly different between two groups, with 69.1% and 71.1%, respectively (P = 0.546). However, patients of aggressive FL reached a plateau in the PFS curve after 2 years. Conclusions Compared with patients of aggressive FL, FL grade 3A patients presented an uncurable feature but associated with a better OS with frontline RCHOP treatment.