{
    "abstract": "While R-CHOP has been one of the standard therapies for untreated high-tumor-burden (HTB) follicular lymphoma (FL) for over 2 decades, obinutuzumab plus bendamustine (OB) is also currently regarded as the standard of care since its approval in 2018 in Japan; however, the long-term efficacy and safety of OB in the daily clinical practice has not been thoroughly evaluated.\nWe conducted a multicenter retrospective study for the clinical outcome of 53 patients with HTB FL treated by OB as the frontline therapy between 2018 and 2021 in the Kyoto Hematology Clinical Study Group (KOTOSG). All patients had at least 2-year follow-up period.\nThe median age was 67, and 60.4% were classified as high risk according to the Follicular Lymphoma International Prognostic Index. The overall and complete response rates after induction therapy with OB were 98% and 83%, respectively. With a median follow-up of 38.5\u00a0months, the 3-year progression-free survival (PFS) and overall survival (OS) were 77.3% and 91.2%, respectively. Grade 3-4 hematological adverse events (AEs) were common, including neutropenia (58.5%) and lymphopenia (98.1%). Non-hematological AEs included infections, such as lung infections, coronavirus disease 2019, and sepsis, with two cases (3.8%) being fatal. Finally, propensity score-matched analysis showed no significant difference in PFS between 46 FL patients treated by the frontline OB and 46 FL patients treated by R-CHOP between 2001 and 2019 in KOTOSG.\nThis study highlighted the need for careful treatment selection based on patient background and disease condition in real-world practice with more elderly patients.",
    "authors": [
        {
            "affiliation": "Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan.",
            "firstname": "Hiroaki",
            "initials": "H",
            "lastname": "Nagata"
        },
        {
            "affiliation": "Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan. ttsuka@koto.kpu-m.ac.jp.",
            "firstname": "Taku",
            "initials": "T",
            "lastname": "Tsukamoto"
        },
        {
            "affiliation": "Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.",
            "firstname": "Tsutomu",
            "initials": "T",
            "lastname": "Kobayashi"
        },
        {
            "affiliation": "Department of Hematology, Omihachiman Community Medical Center, Omihachiman, Japan.",
            "firstname": "Ryoichi",
            "initials": "R",
            "lastname": "Takahashi"
        },
        {
            "affiliation": "Department of Hematology, Omihachiman Community Medical Center, Omihachiman, Japan.",
            "firstname": "Akira",
            "initials": "A",
            "lastname": "Okano"
        },
        {
            "affiliation": "Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.",
            "firstname": "Hitoji",
            "initials": "H",
            "lastname": "Uchiyama"
        },
        {
            "affiliation": "Department of Hematology, Panasonic Health Insurance Organization Matsushita Memorial Hospital, Moriguchi, Japan.\nDepartment of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.",
            "firstname": "Eri",
            "initials": "E",
            "lastname": "Kawata"
        },
        {
            "affiliation": "Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.",
            "firstname": "Nobuhiko",
            "initials": "N",
            "lastname": "Uoshima"
        },
        {
            "affiliation": "Department of Hematology, Aiseikai Yamashina Hospital, Kyoto, Japan.",
            "firstname": "Hiroto",
            "initials": "H",
            "lastname": "Kaneko"
        },
        {
            "affiliation": "Department of Hematology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center, Kyoto, Japan.",
            "firstname": "Shin-Ichi",
            "initials": "SI",
            "lastname": "Fuchida"
        },
        {
            "affiliation": "Department of Hematology, Fukuchiyama City Hospital, Fukuchiyama, Japan.",
            "firstname": "Daichi",
            "initials": "D",
            "lastname": "Nishiyama"
        },
        {
            "affiliation": "Department of Internal Medicine, Otsu City Hospital, Otsu, Japan.",
            "firstname": "Mitsushige",
            "initials": "M",
            "lastname": "Nakao"
        },
        {
            "affiliation": "Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan.",
            "firstname": "Takahiro",
            "initials": "T",
            "lastname": "Fujino"
        },
        {
            "affiliation": "Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan.",
            "firstname": "Shinsuke",
            "initials": "S",
            "lastname": "Mizutani"
        },
        {
            "affiliation": "Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan.",
            "firstname": "Yuji",
            "initials": "Y",
            "lastname": "Shimura"
        },
        {
            "affiliation": "Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, Kyoto, 602-8566, Japan. junkuro@koto.kpu-m.ac.jp.",
            "firstname": "Junya",
            "initials": "J",
            "lastname": "Kuroda"
        }
    ],
    "conclusions": "This study highlighted the need for careful treatment selection based on patient background and disease condition in real-world practice with more elderly patients.",
    "copyrights": "\u00a9 2025. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.",
    "doi": "10.1007/s10147-025-02691-8\n10.1038/s41408-020-00340-z\n10.1200/JCO.2012.45.0866\n10.1200/JCO.2017.74.1652\n10.1016/S0140-6736(12)61763-2\n10.1182/blood-2013-11-531327\n10.1200/JCO.18.00605\n10.1056/NEJMoa1614598\n10.1002/jha2.904\n10.1007/s12185-018-2497-0\n10.17219/acem/157290\n10.1097/HS9.0000000000000807\n10.1182/blood-2016-01-643569\n10.1200/JCO.2013.54.8800\n10.1200/JCO.2006.09.2403\n10.1038/bmt.2012.244\n10.1200/JCO.2017.76.8960\n10.1016/j.clml.2018.11.010\n10.1634/theoncologist.2017-0037\n10.1007/s00277-020-04171-7\n10.3389/fonc.2023.1120967\n10.1002/hon.3184\n10.3390/cancers16071285\n10.1007/s00277-022-05037-w\n10.1007/s00277-023-05306-2\n10.1200/JCO.2008.18.1495\n10.1093/annonc/mds429\n10.1182/blood-2003-12-4434\n10.3960/jslrt.52.77\n10.1200/JCO.2008.21.3991\n10.1182/blood-2017-11-816405\n10.1016/S1470-2045(15)00169-2\n10.1182/blood.V48.1.41.41\n10.1007/BF03003191\n10.1182/blood.V66.6.1358.1358\n10.3324/haematol.2010.036277\n10.1182/bloodadvances.2018016782\n10.1007/s00277-016-2668-0\n10.1093/annonc/mdw185\n10.1016/j.clml.2017.07.002\n10.1097/HS9.0000000000000919\n10.1038/s41408-023-00897-5\n10.2147/IDR.S396271\n10.1007/s12185-022-03305-z\n10.1182/blood-2006-03-013193",
    "journal": "International journal of clinical oncology",
    "keywords": [
        "Bendamustine",
        "Follicular lymphoma",
        "Obinutuzumab",
        "Real-world data",
        "Rituximab"
    ],
    "methods": null,
    "publication_date": "2025-01-08",
    "pubmed_id": "39776016\n32678074\n23530110\n29095677\n23433739\n24591201\n30811293\n28976863\n38895085\n30027429\n36603138\n36407092\n26980727\n25113753\n17242396\n23208313\n29856692\n30581160\n29317554\n32734548\n36969038\n37246287\n38610963\n36369496\n37335322\n19204203\n23041589\n15126323\n22706536\n19652063\n29666118\n26256760\n820387\n3057297\n3933594\n21508124\n29615413\n27103007\n27117536\n28789937\n37404773\n37666820\n36721633\n35188650\n16835383",
    "results": "The median age was 67, and 60.4% were classified as high risk according to the Follicular Lymphoma International Prognostic Index. The overall and complete response rates after induction therapy with OB were 98% and 83%, respectively. With a median follow-up of 38.5\u00a0months, the 3-year progression-free survival (PFS) and overall survival (OS) were 77.3% and 91.2%, respectively. Grade 3-4 hematological adverse events (AEs) were common, including neutropenia (58.5%) and lymphopenia (98.1%). Non-hematological AEs included infections, such as lung infections, coronavirus disease 2019, and sepsis, with two cases (3.8%) being fatal. Finally, propensity score-matched analysis showed no significant difference in PFS between 46 FL patients treated by the frontline OB and 46 FL patients treated by R-CHOP between 2001 and 2019 in KOTOSG.",
    "title": "The real-world efficacy and safety of frontline therapy of obinutuzumab plus bendamustine for untreated high-tumor-burden follicular lymphoma.",
    "xml": "<Element 'PubmedArticle' at 0x788505d03bf0>"
}