Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY.
Blood. 2019 Apr 4;133(14):1540-1547. doi: 10.1182/blood-2018-08-822148. Epub 2019 Jan 30.
Follicular lymphoma (FL) is the most frequently occurring indolent non-Hodgkin lymphoma, with generally favorable outcomes but a variable clinical course. Recent studies have elucidated the consistent and reproducible frequency of early disease progression in FL, occurring in ∼20% of patients. Relapse of FL within 24 months of chemoimmunotherapy (POD24) is now established as a robust marker of poor survival, leading to increased risk of death. Currently, there is no established method of identifying patients at risk for early disease progression at the time of their FL diagnosis. However, numerous studies worldwide are investigating clinical, pathologic, and radiographic biomarkers to help predict POD24, thereby improving subsequent outcomes and adapting therapy based on individual risk. There is also a paucity of standardized treatments for patients with POD24, but investigations are ongoing testing novel targeted therapies and autologous stem cell transplantation strategies. This review provides an overview of early-relapsing FL and our approach to patient management based on recent available data.
滤泡性淋巴瘤（FL）是最常见的惰性非霍奇金淋巴瘤，通常预后良好，但临床病程多变。最近的研究阐明了 FL 早期疾病进展的一致性和可重复性，约 20%的患者发生这种情况。化疗免疫治疗后 24 个月内（POD24）的 FL 复发现在被确立为不良生存的有力标志物，导致死亡风险增加。目前，在 FL 诊断时，尚无确定方法可以识别早期疾病进展风险患者。然而，世界各地的许多研究正在调查临床、病理和影像学生物标志物，以帮助预测 POD24，从而改善后续结果，并根据个体风险调整治疗。对于 POD24 的患者，也缺乏标准化的治疗方法，但正在进行研究以测试新型靶向治疗和自体干细胞移植策略。本综述概述了早期复发的 FL 以及我们根据最近可用数据对患者管理的方法。
