Follicular lymphoma. Controlled Clinical Trial with An Integral Therapy in Untreated Patients

Follicular lymphoma (FL) is the second most frequent non-Hodgkin lymphoma, and until now the best treatment has not been defined, most studies show an excellent Overall Survival (OS), but relapse is observed at very short time. Thus, actually the goal of most studies is to Increase Progression-free survival (PFS) Patients and Methods: We developed an regimen on patients with FL, untreated, stage III-IV, to include: 6 cycles of CHOP (cyclophosphamide, vincristine, doxorubicin and prednisone), if the patient achieve Complete response (CR) patients received 375 mg/m2 at monthly cycles (days 1,8,15) for six months. Subsequently were allocated in a proportion1:1: thalidomide, 100 mg, oral, days 1 to 21, at monthly interval for 3 years. Results: CR was achieved in 701 (91%); 343 patients received thalidomide an 358 were the control group. PFS in maintenance group was 88% (95% Confidence Interval: 82%-965) and OS was 93% (95CI: 87%-97%), that were statistical better that the control group: 69% (61%-77%) Conclusion: The use of a continuous chemotherapy: induction, consolidation with rituximab and maintenance with low doses of thalidomide, achieve excellent response because significantly increase PFS and OS.