Long term results of a new treatment strategy for follicular low grade lymphoma (FLGL).

e19035 Background: FLGL usually presents with widespread but asymptomatic lymphadenopathy, low SUVs on PET and normal LDH. It's considered incurable and standard of care has been 'watch and wait' (W a relapse occurred in only 5 (7%). Our PFS 10 yr for favorable FLIPI-2 (score 0)= 97%, for intermediate (1-2) =88%, unfavorable (3-5)= 72% (p=.15). Our PFS results were consistently superior to literature data across all FLIPI-2 scores. Transformation to DLBCL= 6/186 (3%) compared to 20-30% historical controls; 5 of 6 transformations were in cases with CDIH and 4 occurred within 3 yrs. Early (<2 yr) relapse rate= 2% in contrast with 20% literature data; all 4 early relapses were CDIH. Conclusions: Our findings emphasize several advantages of initiating treatment early and basing it on presence or absence of CDIH. Our data highlight the need to 1- identify CDIH for potential use of doxorubicin treatment. 2- CDIH as prognostic factor seems more effective than FLIPI-2. 3- PFS 10 yr results are remarkably superior to both literature controls and to our previous experience at MDACC with FND-R. 4- Only 7% relapses beyond 10 yrs suggest potential for cure, according to our results and those from MDACC. Table: see text