{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:42:32Z","timestamp":1761896552282,"version":"3.37.3"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T00:00:00Z","timestamp":1493769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008893","name":"University of Iowa","doi-asserted-by":"publisher","award":["CA97274"],"award-info":[{"award-number":["CA97274"]}],"id":[{"id":"10.13039\/100008893","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Histological transformation (<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>) of follicular lymphoma (<jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>) to an aggressive lymphoma after chemotherapy remains a key issue. The incidence of <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> after radioimmunotherapy (<jats:styled-content style=\"fixed-case\">RIT<\/jats:styled-content>) is unknown. This single institution study analysed the risk of <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content> after treatment with yttrium\u201090 ibritumomab tiuxetan in 115 consecutive patients treated during 1987\u20132012. <jats:styled-content style=\"fixed-case\">RIT<\/jats:styled-content> was administered for progressive <jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content> in 111 (97%) patients and as first\u2010line therapy in the remaining 4. 28% (<jats:italic>n<\/jats:italic>\u00a0=\u00a032) had <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>, occurring at a median of 60\u00a0months from diagnosis and 20\u00a0months after <jats:styled-content style=\"fixed-case\">RIT<\/jats:styled-content>. 48% (12\/25) of patients who received fludarabine developed <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>. The estimated 10\u2010year risk of <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> in the fludarabine and non\u2010fludarabine groups was 67% and 26% respectively (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0\u00b7015). Only prior fludarabine was significantly associated with predicting the risk of <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> after <jats:styled-content style=\"fixed-case\">RIT<\/jats:styled-content>. 8% (9\/115) of patients developed therapy\u2010related myelodysplastic syndrome\/acute myeloid leukaemia (<jats:styled-content style=\"fixed-case\">tMDS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AML<\/jats:styled-content>) at a median of 41\u00b74\u00a0months (range, 5\u201389). The estimated 10\u2010year risk of <jats:styled-content style=\"fixed-case\">tMDS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AML<\/jats:styled-content> in non\u2010fludarabine treated patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a090) <jats:italic>versus<\/jats:italic> fludarabine treated (<jats:italic>n<\/jats:italic>\u00a0=\u00a025) was 13% and 29%, respectively. The estimated overall risk of <jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content> undergoing <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> at 10\u00a0years without fludarabine exposure appears similar to patients reported in the literature that have not received <jats:styled-content style=\"fixed-case\">RIT<\/jats:styled-content>. Patients with prior purine\u2010analogue therapy are at significantly higher risk of HT.<\/jats:p>","DOI":"10.1111\/bjh.14688","type":"journal-article","created":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T08:22:44Z","timestamp":1493799764000},"page":"427-433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Risk of histological transformation and therapy\u2010related myelodysplasia\/acute myeloid leukaemia in patients receiving radioimmunotherapy for follicular lymphoma"],"prefix":"10.1111","volume":"178","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8216-3457","authenticated-orcid":false,"given":"Narendranath","family":"Epperla","sequence":"first","affiliation":[{"name":"Department of Hematology\/Oncology Medical College of Wisconsin Milwaukee WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony Q.","family":"Pham","sequence":"additional","affiliation":[{"name":"Department 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