Sarkozy Clémentine, Salles Gilles
Inserm U1052 CNRS 5286, centre de recherche en cancérologie de Lyon (CRCL), équipe « clinical and experimental models of lymphomagenesis », 69600 Lyon, France; Université de Lyon, université Claude-Bernard Lyon 1, faculté de médecine et de maïeutique Lyon-Sud-Charles-Mérieux, 69600 Lyon, France.
Inserm U1052 CNRS 5286, centre de recherche en cancérologie de Lyon (CRCL), équipe « clinical and experimental models of lymphomagenesis », 69600 Lyon, France; Université de Lyon, université Claude-Bernard Lyon 1, faculté de médecine et de maïeutique Lyon-Sud-Charles-Mérieux, 69600 Lyon, France; Groupement hospitalier Sud, hospices civils de Lyon, service d'hématologie clinique, 69310 Lyon, France.
Presse Med. 2019 Jul-Aug;48(7-8 Pt 1):859-870. doi: 10.1016/j.lpm.2019.07.025. Epub 2019 Aug 22.
Non-follicular small cell lymphomas include several entities whose clinical and pathological descriptions have been refined in the last 20 years. MALT lymphoma, developed at the expense of lymphoid tissue associated with the mucosa, is usually localized to a given organ, but can also disseminate. Some patients with MALT lymphoma can be treated by eradicating the associated infectious agent, whereas local treatment should be preferred for other cases ; disseminated forms and relapsed patients are eligible for anti-CD20 antibodies associated with cytotoxic agents. Patients with mantle cell lymphoma have benefited from many advances, including the use of cytarabine and bendamustine, anti-CD20 antibodies, intensive treatments (autograft) and recently targeted therapy (ibrutinib, inhibitor or the Bruton tyrosine kinase). Patients with splenic nodal marginal zone lymphomas should be evaluated for different options, of which immunochemotherapy remains important. For all these entities, the implementation of treatments may be delayed by several years for certain groups of patients. Although considered as incurable, the prognosis of these pathologies has improved significantly and the majority of patients will be able to live for many years with often treatment-free intervals.
非滤泡性小细胞淋巴瘤包括几个实体,其临床和病理描述在过去20年中得到了完善。黏膜相关淋巴组织淋巴瘤起源于与黏膜相关的淋巴组织,通常局限于某一特定器官,但也可发生播散。一些黏膜相关淋巴组织淋巴瘤患者可通过根除相关感染因子进行治疗,而其他病例则应首选局部治疗;播散型和复发患者适合使用与细胞毒性药物联合的抗CD20抗体治疗。套细胞淋巴瘤患者受益于许多进展,包括阿糖胞苷和苯达莫司汀的使用、抗CD20抗体、强化治疗(自体移植)以及最近的靶向治疗(伊布替尼,布鲁顿酪氨酸激酶抑制剂)。脾边缘区淋巴瘤患者应评估不同的治疗选择,其中免疫化疗仍然很重要。对于所有这些实体,某些患者群体的治疗实施可能会延迟数年。尽管被认为无法治愈,但这些疾病的预后已显著改善,大多数患者通常在无治疗间隔的情况下能够存活多年。