Fukuhara Noriko
Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine.
Rinsho Ketsueki. 2017;58(10):2020-2025. doi: 10.11406/rinketsu.58.2020.
Follicular lymphoma (FL) is incurable with the current standard therapeutic strategy, although the natural history of FL has improved in the last few decades. Treatment strategy for FL is considered by stage and tumor burden. For advanced-stage FL patients with low tumor burden, monitoring remains an appropriate approach. Single agent rituximab is also suggested as a good alternative. The addition of rituximab to chemotherapy has improved overall survival in advanced-stage FL patients with high tumor burden. The optimal chemotherapy to partner with rituximab might be CHOP or bendamustine. Rituximab maintenance after successful induction rituximab-based chemotherapy prolongs PFS. Recently, progression within 24 months of first-line chemotherapy has been established as a predictor of inferior outcome, with a 50% risk of death in 5 years. Addressing this high-risk group is important for optimal future treatment strategies.
滤泡性淋巴瘤(FL)采用当前的标准治疗策略无法治愈,尽管在过去几十年中FL的自然病程已有改善。FL的治疗策略根据分期和肿瘤负荷来考虑。对于肿瘤负荷低的晚期FL患者,监测仍然是一种合适的方法。也建议将单药利妥昔单抗作为一个不错的选择。在肿瘤负荷高的晚期FL患者中,化疗联合利妥昔单抗可改善总生存期。与利妥昔单抗联合使用的最佳化疗方案可能是CHOP或苯达莫司汀。基于利妥昔单抗的诱导化疗成功后进行利妥昔单抗维持治疗可延长无进展生存期(PFS)。最近,一线化疗24个月内出现疾病进展已被确立为预后较差的预测指标,5年内死亡风险为50%。针对这一高危群体对于优化未来治疗策略很重要。