Sujobert Pierre, Salles Gilles
Groupement hospitalier Sud, hospices civils de Lyon, service d'hématologie biologique, 69310 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.
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):850-858. doi: 10.1016/j.lpm.2019.07.024. Epub 2019 Aug 22.
Follicular lymphoma, the second most common lymphoma, is characterized by its slow growth and is often considered incurable in advanced stages. Progresses in biology have contributed to better understand the complex and successive mechanisms of development of this pathology, whose diagnosis is based on a lymph node biopsy. However, the prognosis of the patients is heterogeneous and several indexes have been proposed to identify groups of patients with a similar life expectancy, in order to guide the therapeutic choices. The treatment has been modified in the last 20 years by the emergence of anti-CD20 monoclonal antibodies which constitute, alone or in combination, of the cornerstone of therapeutic management. After staging using, in particular, 18-fluorodeoxyglucose positron emission tomography, the therapeutic strategy will be adapted for each patient, ranging from simple watchful waiting to a combination of chemotherapy and anti-CD20 antibodies. Relapses (which often require a new lymph node biopsy to eliminate a possible histological transformation into an aggressive lymphoma with poorer prognosis) remain common but are still accessible to effective therapeutic interventions. Thanks to these advances, the median life expectancy of patients with follicular lymphoma now exceeds 15 years.
滤泡性淋巴瘤是第二常见的淋巴瘤,其特点是生长缓慢,晚期通常被认为无法治愈。生物学的进展有助于更好地理解这种疾病复杂且连续的发展机制,其诊断基于淋巴结活检。然而,患者的预后存在异质性,已经提出了几个指标来识别预期寿命相似的患者群体,以指导治疗选择。在过去20年中,抗CD20单克隆抗体的出现改变了治疗方式,这些抗体单独或联合使用构成了治疗管理的基石。在使用18-氟脱氧葡萄糖正电子发射断层扫描等进行分期后,治疗策略将根据每位患者进行调整,从单纯的观察等待到化疗与抗CD20抗体联合使用。复发(通常需要再次进行淋巴结活检以排除可能转变为预后较差的侵袭性淋巴瘤的组织学变化)仍然很常见,但仍可通过有效的治疗干预来应对。由于这些进展,滤泡性淋巴瘤患者的中位预期寿命现在超过了15年。