TY - JOUR
T1 - 'Watch and wait' as initial management for patients with follicular lymphomas
T2 - Still a viable strategy?
AU - Hagemeister, Fredrick B.
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012
Y1 - 2012
N2 - Observation until the development of symptoms, or 'watch and wait', has long been a proposed management technique for patients with indolent lymphomas. However, investigators have found that there may be differences in outcomes for various patient groups according to histopathology, clinical features of the disease, biologic factors as yet to be fully recognized, and type of initial therapy offered. Recently, investigators from the UK National Cancer Research Institute reported that progression-free results were significantly improved when asymptomatic patients with indolent follicular lymphomas received initial therapy with single-agent rituximab rather than when they underwent observation alone. These results were further improved when they received maintenance rituximab. Time to chemotherapy was also longer when these patients received initial therapy with rituximab, thereby delaying the need for such treatment. However, overall survival rates for patients who received rituximab as initial therapy were similar to those for patients who underwent initial 'watch and wait'. Future studies should concentrate on risks of such management, including cost effectiveness of such treatments and development of resistance to subsequent therapies. Adis
AB - Observation until the development of symptoms, or 'watch and wait', has long been a proposed management technique for patients with indolent lymphomas. However, investigators have found that there may be differences in outcomes for various patient groups according to histopathology, clinical features of the disease, biologic factors as yet to be fully recognized, and type of initial therapy offered. Recently, investigators from the UK National Cancer Research Institute reported that progression-free results were significantly improved when asymptomatic patients with indolent follicular lymphomas received initial therapy with single-agent rituximab rather than when they underwent observation alone. These results were further improved when they received maintenance rituximab. Time to chemotherapy was also longer when these patients received initial therapy with rituximab, thereby delaying the need for such treatment. However, overall survival rates for patients who received rituximab as initial therapy were similar to those for patients who underwent initial 'watch and wait'. Future studies should concentrate on risks of such management, including cost effectiveness of such treatments and development of resistance to subsequent therapies. Adis
KW - Chlorambucil
KW - Follicular-lymphoma
KW - Interferon-alpha
KW - Maintenance-therapy
KW - Prednimustine
KW - Rituximab
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U2 - 10.2165/11634320-000000000-00000
DO - 10.2165/11634320-000000000-00000
M3 - Review article
C2 - 23057946
AN - SCOPUS:84868149256
SN - 1173-8804
VL - 26
SP - 363
EP - 376
JO - BioDrugs
JF - BioDrugs
IS - 6
ER -