{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:23:00Z","timestamp":1791868980127,"version":"4.3.4"},"reference-count":50,"publisher":"American Society of Hematology","issue":"18","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,9,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>High-dose therapy and autologous stem cell transplantation (HDT\/ASCT) is an effective salvage treatment for eligible patients with follicular lymphoma (FL) and early progression of disease (POD). Since the introduction of rituximab, HDT\/ASCT is no longer recommended in first remission. We here explored whether consolidative HDT\/ASCT improved survival in defined subgroups of previously untreated patients. We report survival analyses of 431 patients who received frontline rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) for advanced FL, and were randomized to receive consolidative HDT\/ASCT. We performed targeted genotyping of 157 diagnostic biopsies, and calculated genotype-based risk scores. HDT\/ASCT improved failure-free survival (FFS; hazard ratio [HR], 0.8, P = .07; as-treated: HR, 0.7, P = .04), but not overall survival (OS; HR, 1.3, P = .27; as-treated: HR, 1.4, P = .13). High-risk cohorts identified by FL International Prognostic Index (FLIPI), and the clinicogenetic risk models m7-FLIPI and POD within 24 months\u2013prognostic index (POD24-PI) comprised 27%, 18%, and 22% of patients. HDT\/ASCT did not significantly prolong FFS in high-risk patients as defined by FLIPI (HR, 0.9; P = .56), m7-FLIPI (HR, 0.9; P = .91), and POD24-PI (HR, 0.8; P = .60). Similarly, OS was not significantly improved. Finally, we used a machine-learning approach to predict benefit from HDT\/ASCT by genotypes. Patients predicted to benefit from HDT\/ASCT had longer FFS with HDT\/ASCT (HR, 0.4; P = .03), but OS did not reach statistical significance. Thus, consolidative HDT\/ASCT after frontline R-CHOP did not improve OS in unselected FL patients and subgroups selected by genotype-based risk models.<\/jats:p>","DOI":"10.1182\/bloodadvances.2020002546","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T17:08:03Z","timestamp":1600362483000},"page":"4451-4462","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":11,"title":["Evaluating upfront high-dose consolidation after R-CHOP for follicular lymphoma by clinical and genetic risk models"],"prefix":"10.1182","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6825-702X","authenticated-orcid":false,"given":"Stefan","family":"Alig","sequence":"first","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"},{"name":"Division of Oncology, Department of Medicine, Stanford University, Stanford, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vindi","family":"Jurinovic","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"},{"name":"Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Shahrokh Esfahani","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Medicine, Stanford University, Stanford, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Haebe","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Passerini","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-3037","authenticated-orcid":false,"given":"Johannes C.","family":"Hellmuth","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Gaitzsch","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Keay","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natyra","family":"Tahiri","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Zoellner","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Rosenwald","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of W\u00fcrzburg, and Comprehensive Cancer Center Mainfranken, W\u00fcrzburg, 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Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5896-3200","authenticated-orcid":false,"given":"Annette M.","family":"Staiger","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, Germany;"},{"name":"Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany;"},{"name":"University of T\u00fcbingen, T\u00fcbingen, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Horn","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, Germany;"},{"name":"Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany;"},{"name":"University of T\u00fcbingen, T\u00fcbingen, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin L.","family":"Hansmann","sequence":"additional","affiliation":[{"name":"Senckenberg Institute of Pathology, Goethe University, Frankfurt am Main, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Pott","sequence":"additional","affiliation":[{"name":"Second Medical Department, University Hospital Schleswig-Holstein, Kiel, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Unterhalt","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich, 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