Department of Pathology, Radboud university medical center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands; Pathology-DNA, location Rijnstate, Wagnerlaan 55, 6815AD Arnhem, The Netherlands.
Department of Pathology, Radboud university medical center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands.
Blood Rev. 2017 Nov;31(6):426-435. doi: 10.1016/j.blre.2017.08.002. Epub 2017 Aug 5.
Although patients with indolent B-cell lymphomas have a relatively good survival rate, conventional chemotherapy is not curative. Disease courses are typically characterized by multiple relapses and progressively shorter response duration with subsequent lines of therapy. There has been an explosion of innovative targeted agents in the past years. This review discusses current knowledge on the etiology of indolent B-cell lymphomas with respect to the role of micro-organisms, auto-immune diseases, and deregulated pathways caused by mutations. In particular, knowledge on the mutational landscape of indolent B-cell lymphomas has strongly increased in recent years and harbors great promise for more accurate decision making in the current wide range of therapeutic options. Despite this promise, only in chronic lymphocytic leukemia the detection of TP53 mutations and/or del17p currently have a direct effect on treatment decisions. Nevertheless, it is expected that in the near future the role of genetic testing will increase for prediction of response to targeted treatment as well as for more accurate prediction of prognosis in indolent B-cell lymphomas.
尽管惰性 B 细胞淋巴瘤患者的存活率相对较高，但常规化疗并不能治愈该病。疾病过程通常表现为多次复发，随后的治疗线反应持续时间越来越短。在过去的几年中，出现了大量创新的靶向药物。本文讨论了惰性 B 细胞淋巴瘤病因学的最新知识，包括微生物、自身免疫性疾病以及突变引起的失调途径的作用。特别是，近年来，对惰性 B 细胞淋巴瘤的突变景观的了解有了很大的提高，这为在当前广泛的治疗选择中做出更准确的决策提供了很大的希望。尽管有这样的前景，但只有在慢性淋巴细胞白血病中，TP53 突变和/或 del17p 的检测目前直接影响治疗决策。然而，预计在不久的将来，基因检测的作用将增加，以预测对靶向治疗的反应，以及更准确地预测惰性 B 细胞淋巴瘤的预后。
