Servicio de Hematología, Hospital Clínic, Barcelona, España.
Servicio de Hematología, ICO-IJC-Hospital Germans Trias i Pujol, Badalona, España.
Med Clin (Barc). 2021 Nov 12;157(9):440-448. doi: 10.1016/j.medcli.2021.03.041. Epub 2021 Jun 29.
Follicular lymphoma, the most common indolent lymphoma, originates from germinal centre B-cells of the lymphoid follicle, and is characterized by t(14;18). Clinical manifestations include the presence of lymphadenopathy, sometimes accompanied by constitutional symptoms or cytopenia. Diagnosis is established through the identification of a B-cell proliferation of nodular pattern in the lymph node biopsy. Upon staging with PET-CT and bone marrow biopsy, a significant proportion of patients do not need immediate treatment. When therapy is indicated, commonly used regimens include anti-CD20 immunotherapy with or without chemotherapy. Although overall survival for most patients is prolonged, relapses are very frequent, and early relapse and transformation to an aggressive lymphoma portend a much worse prognosis. New therapies are under development, which will most likely change outcomes for FL patients in the near future.
滤泡性淋巴瘤是最常见的惰性淋巴瘤，起源于淋巴滤泡的生发中心 B 细胞，其特征在于 t(14;18)。临床表现包括淋巴结病的存在，有时伴有全身症状或细胞减少症。通过识别淋巴结活检中的结节状 B 细胞增殖来确立诊断。通过 PET-CT 和骨髓活检进行分期后，很大一部分患者不需要立即治疗。当需要治疗时，常用的方案包括抗 CD20 免疫疗法联合或不联合化疗。尽管大多数患者的总生存期延长，但复发非常频繁，早期复发和转化为侵袭性淋巴瘤预示着预后更差。新的治疗方法正在开发中，这很可能在不久的将来改变滤泡性淋巴瘤患者的结局。
