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Data on the cumulative incidence of secondary malignancies postrelapse after conventional immunochemotherapy are scarce. A long\u2010term analysis of rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisone (R\u2010CHOP) as first\u2010line treatment was conducted in a randomised clinical trial. A six\u2010cycle R\u2010CHOP regimen was administered every 2 or 3\u2009weeks without rituximab maintenance. A prespecified evaluation was conducted 15\u2009years after the completion of enrolment, following initial analysis results that showed no significant differences in outcomes at the 3\u2010year mark. In\u2010depth analyses were performed on the cohort of 248 patients with FL who were allocated to the two treatment arms. With a median follow\u2010up period of 15.9\u2009years, the 15\u2010year OS was 76.2%. There were no protocol treatment\u2010related deaths, nor were there any fatal infections attributable to subsequent lymphoma treatment. At 15\u2009years, the cumulative incidence of non\u2010haematological and haematological malignancies was 12.8% and 3.7% respectively. Histological transformation appeared after a median of 8\u2009years. R\u2010CHOP maintains safety and efficacy in patients with advanced FL over extended follow\u2010up, making it a viable first\u2010line option for patients with advanced\u2010stage FL.<\/jats:p>","DOI":"10.1111\/bjh.19213","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T19:49:14Z","timestamp":1700855354000},"page":"849-860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["<scp>R\u2010CHOP<\/scp>\n                    treatment for patients with advanced follicular lymphoma: Over 15\u2010year follow\u2010up of\n                    <scp>JCOG0203<\/scp>"],"prefix":"10.1111","volume":"204","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5905-2097","authenticated-orcid":false,"given":"Takashi","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Haematology National Cancer Center Hospital  Tokyo 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