Introduction:
Due to the rarity of the disease, outcomes and treatment patterns of follicular lymphoma (FL) with POD24 (progressed within 24 months of diagnosis) in daily practice have been poorly defined in Korea.

Material and methods:
Clinical data were retrospectively collected from patients who met the following criteria: 1) histologically confirmed diagnosis of FL; 2) POD24; 3) available medical records. The primary endpoint was overall survival (OS) from the first diagnosis of FL.

Results:
From 2007 to 2019, 73 cases were eligible for analysis. The median age was 53 years, and 62 patients had received rituximab as induction treatment. POD24 was documented after a median duration of 11.6 months. For salvage treatment, platinum-based combinations (N=23) were the most used chemotherapy backbone followed by bendamustine- (N=15) and fludarabine-based combinations (N=12). The median progression-free survival (PFS) from the first progression was 23.7 months. The median OS was 128.9 months, with the 5-year OS rate being 75.2%. OS did not significantly differ by the reinduction regimen, the use of rituximab, or stem cell transplantation. When we compared these patients with 147 FL patients without POD24, the 5-year survival rate was significantly inferior in the current cohort (75.2% vs. 95.7%, p < 0.001).

Conclusions:
The current study revealed that patients with early progressed FL have poor outcomes, in agreement with the findings of previous studies. Given that no existing treatment can overcome their poor prognosis, novel therapeutic approaches are needed.