From the Guidelines
The overall survival rate for B cell lymphoma has significantly improved with the introduction of targeted therapies, with follicular lymphoma patients now having a median overall survival exceeding 18 years, as reported in the most recent studies 1. The survival rate for B cell lymphoma varies significantly depending on the specific type, stage at diagnosis, and individual patient factors.
- For follicular lymphoma, the 5-year overall survival (OS) rate can be as high as 80-90%, though this type tends to be indolent but often recurs.
- Patients with progression of disease (POD) within less than 24 months of diagnosis and failure to achieve event-free survival at 12 months after initial treatment with chemoimmunotherapy have been identified as prognostic indicators of poor survival, with a 5-year OS rate of 50% for patients with POD < 2 years after first-line therapy with R-CHOP, as seen in the National LymphoCare Study 1.
- Treatment regimens typically include chemotherapy combinations like R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) for certain types of B cell lymphoma, with specific protocols varying by lymphoma type.
- The introduction of targeted therapies like rituximab has significantly improved survival rates over the past two decades by specifically targeting the CD20 protein on B cells, enhancing the effectiveness of traditional chemotherapy while reducing side effects, as demonstrated in several major prospective randomized studies 1. Based on the most recent and highest quality evidence, the current approach to frontline therapy for follicular lymphoma is most often based on stage and burden of disease, with rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP), rituximab, cyclophosphamide, vincristine, prednisone (R-CVP), and rituximab, bendamustine (BR) being commonly used regimens 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Survival Rate of B Cell Lymphoma
- The prognosis of diffuse large B-cell lymphoma (DLBCL) has improved significantly over the last decade, mainly due to the addition of rituximab to chemotherapy 2.
- A study found that the 3-year survival after relapse was better in late relapsing patients (48% vs. 25%, P=0·03), but the survival at 5 years (32% vs. 20%) and 10 years (13% vs. 14%) after relapse was not different 3.
- The 2-year overall survival (OS) rate was 82·7% in the R-CHOP-14 group and 80·8% in the R-CHOP-21 group (hazard ratio 0·90,95% CI 0·70-1·15; p=0·3763) 4.
- Obinutuzumab or Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Previously Untreated Diffuse Large B-Cell Lymphoma showed that the 3-year PFS rates were 70% and 67%, respectively 5.
- Integrating novel drugs to chemoimmunotherapy in diffuse large B-cell lymphoma may represent a modern approach in the treatment of DLBCL, with Ibrutinib and lenalidomide showing important results in DLBCL 6.
Factors Affecting Survival Rate
- Age and presence of B-symptoms were found to predict survival after relapse, but not early versus late relapse 3.
- The international prognostic index, which separates patients into three prognostic subgroups (low-risk, intermediate-risk, and high-risk), is based only on clinical variables, and biological prognostic factors should now be part of initial evaluation to guide treatment 2.
- High international prognostic index, poor-prognosis molecular characteristics, and cell of origin were not predictive for benefit from either schedule 4.
Treatment Options
- R-CHOP-21 remains the standard first-line treatment in patients with diffuse large B-cell lymphoma 4.
- The addition of novel drugs such as Bortezomib, Bruton's tyrosine kinase, IMiDs, Venetoclax, mTOR inhibitors, and other biological agents to standard R-CHOP may represent a modern approach in the treatment of DLBCL 6.
- Ibrutinib and lenalidomide showed important results in DLBCL and the integration of these drugs in first-line treatment is under investigation 6.