Salles Gilles A
Centre Hospitalier Lyon-Sud, 165, Ch du Grand Revoyet, 69495 Pierre-Benite, France.
Hematology Am Soc Hematol Educ Program. 2007:216-25. doi: 10.1182/asheducation-2007.1.216.
Follicular lymphoma constitutes the most frequent indolent lymphoma, well characterized by its clinical presentation related to nodal involvement and its morphologic and biologic features. Some rare locations of extranodal involvement, such as the gastrointestinal tract or skin, were recently further refined. The description of the Follicular Lymphoma International Prognostic Index (FLIPI) represents an important step in identifying patient subgroups with predictable outcome and comparing the results of clinical trials, although its use in clinical practice remains to be established. Analyses of gene expression profiles or constitutive gene variations may also provide additional insights for prognostication in the near future. Furthermore, these data underline the complex interactions between the tumor cells and their microenvironment; recent attempts to translate these findings with immunohistochemical studies remain unable to robustly predict patient outcome. The therapeutic strategies in follicular lymphoma have been transformed by monoclonal antibodies, used alone or in combination with chemotherapy. Treatment options should be adapted to the clinical features at diagnosis and appear to be able to modify the overall survival of some subgroups of patients. Further efforts may focus on strategies that can alter the natural history of this disease.
滤泡性淋巴瘤是最常见的惰性淋巴瘤，其临床表现与淋巴结受累相关，形态学和生物学特征也很典型。一些罕见的结外受累部位，如胃肠道或皮肤，最近得到了进一步明确。滤泡性淋巴瘤国际预后指数（FLIPI）的描述是识别预后可预测的患者亚组以及比较临床试验结果的重要一步，尽管其在临床实践中的应用仍有待确立。基因表达谱或组成性基因变异的分析在不久的将来也可能为预后提供更多见解。此外，这些数据强调了肿瘤细胞与其微环境之间复杂的相互作用；最近通过免疫组化研究转化这些发现的尝试仍无法可靠地预测患者预后。单克隆抗体单独或与化疗联合使用，已经改变了滤泡性淋巴瘤的治疗策略。治疗方案应根据诊断时的临床特征进行调整，似乎能够改变某些患者亚组的总生存期。进一步的努力可能集中在能够改变这种疾病自然病程的策略上。
