Duodenal-type follicular lymphoma more than 10 years after treatment intervention: A retrospective single-center analysis

Table 1 Clinical features of five patients

Case	Age	Sex	Trigger to be found	PS	Grade	Distal intestinal lesion	Extra-duodenal lesion	Initial stage	FLIPI
1	65	F	Screening EGD	0	1	Jejunum	(-)	I	Low
2	63	F	Follow-up for GERD	0	1	Jejunum	Bone marrow	IV	Int
3	40	M	Screening EGD	0	1	Not tested	Bone marrow, mesenteric LN	IV	Low
4	42	M	Screening EGD	0	1	(-)	(-)	I	Low
5	42	M	Screening EGD	0	1	Not tested	(-)	I	Low

PS: Performance status; FLIPI: Follicular lymphoma international prognostic index; F: Female; M: Male; EGD: Esophagogastroduodenoscopy; GERD: Gastroesophageal reflux disease; LN: Lymph nodes; Int: Intermediate.

Table 2 Treatment and outcome of 5 patients

Case	Treatment motive	Initial treatment	Effect	Rituximab maintenance	Relapse lesion/re-Stage (from the end of treatment)	2nd treatment	Outcome (from the 1st onset)
1	Previously followed doctor’s judgment	RTX	1st CR	(-)	Duodenum + cervical LN/Stage IV (1 yr and 3 mo)	R-THP-COP	2nd CR (18 years)
2	In stage IV	R-CVP + R-F	1st CR	(+)	Colon + mesenteric LN/Stage II1 (1 yr and 7 mo)	Watch	2nd CR (12 yr)
3	In stage IV	R-CHOP	1st CR	(+)	(-)	-	1st CR (13 yr)
4	Patient’s request	Radiation + RTX	1st CR	(-)	(-)	-	1st CR (16 yr)
5	Patient’s request	CHOP/RTX/radiation	1st CR	(-)	Lung + systemic LN/Stage IV (13 yr)	B-R/R-BAC/CHOEP/ONTZ	Death due to primary disease (21 yr)

RTX: Rituximab; R-CVP: Rituximab + cyclophosphamide, vincristine, and prednisone; R-F: Rituximab + oral fludarabine; R-CHOP: Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone; R-THP-COP: Rituximab, cyclophosphamide, pirarubicin, vincristine, and prednisone; B-R: Rituximab + bendamustine; R-BAC: Rituximab, bendamustine, and cytarabine; CHOEP: Cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone; ONTZ: Obinutuzumab; LN: Lymph node; CR: Complete remission.