Background: Data on outcomes of follicular lymphoma grade 3B (FL gr.3B) and composite lymphoma (FL/large B-cell lymphoma (B-LCL)) are scarce and the effect of obinutuzumab is unknown. Patients and methods: We analyzed outcomes of patients with FL gr.3B & FL/B-LCL receiving front-line treatment with obinutuzumab-chemotherapy combinations and compared them to previously published cohorts with FL gr.1–3A and diffuse large B-cell lymphoma (DLBCL). Results: Twenty-six patients were included; nine had FL gr.3B and 17 had FL/B-LCL. Response rate was 92%, and 60% achieved complete remission. OS and PFS rates at 3 years were 76% and 67%, respectively. Outcomes of patients with FL gr.3B and FL/B-LCL were similar. PFS and OS rates at 3 years were both 100% in patients with FLIPI 0–2 vs. 42% and 61% in those with FLIPI 3–4 (p = 0.005 and p = 0.031). PFS and OS rates at 3 years were both 100% in patients with IPI 0–2 vs. 29% and 55%, respectively, in those with IPI 3–5 (p = 0.004 and p = 0.014). Low-risk patients with FL gr.3B & FL/B-LCL, FL gr.1–3A and DLBCL all had 3-year OS and PFS rates above 80%. High-risk patients with FL gr.3B & FL/B-LCL had outcomes inferior to those with FL gr. 1–3A and similar to those with DLBCL. Conclusions: Our results suggest that front-line therapy with obinutuzumab-chemotherapy combinations has excellent outcomes in patients with low-risk FL gr.3B & FL/B-LCL, that both FLIPI and IPI are of prognostic value and that the clinical course of FL gr.3B & FL/B-LCL is more similar to DLBCL than FL gr.1–3A.
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Galušić et al. (2026) studied this question.
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