Kamijo Kimimori, Shimomura Yoshimitsu, Yoshioka Satoshi, Yamashita Daisuke, Hara Shigeo, Ishikawa Takayuki
Department of Hematology Kobe City Hospital Organization Kobe City Medical Center General Hospital Chuo-ku Japan.
Department of Environmental Medicine and Population Science Graduate School of Medicine Osaka University Suita Japan.
EJHaem. 2022 Jan 31;3(2):379-384. doi: 10.1002/jha2.384. eCollection 2022 May.
Duodenal-type follicular lymphoma (FL) is a rare and newly recognized disease. Few data are available on the outcomes and treatment strategies for patients with duodenal-type FL. We aimed to investigate the clinical features and outcomes of duodenal-type FL. We defined duodenal-type FL as involvement of the duodenum, without nodal or extranodal lesions other than intestinal lesions, pathologically diagnosed as FL. We reviewed 26 patients with duodenal-type FL between January 2011 and December 2020 at Kobe City Hospital Organization, Kobe City Medical Center General Hospital. In particular, patients were selected for the watch and wait (WW) strategy and followed up with regular esophagogastroduodenoscopy about once a year at our institution. The patient characteristics were as follows: median age 63.5 years (range: 42-78), sex (male, 15; female, 11), stage (I, 26), and grade (I, 26). Regarding treatment strategies, 23 patients were selected for the WW strategy, and three patients received initial rituximab therapy. The median follow-up period was 65.5 months (range: 0.2-109). Five-year progression-free survival and 5-year overall survival rates were 86.3% and 100%, respectively. Among the 23 patients selected for the WW strategy, six had spontaneous complete regression, and 14 had stable disease, and three had progressive disease, including one with histologic transformation. The WW strategy for patients with duodenal-type FL could be an appropriate and safe treatment option. However, in several cases, disease progression was documented, and regular follow-up is important.
十二指肠型滤泡性淋巴瘤（FL）是一种罕见的新发现疾病。关于十二指肠型FL患者的治疗结局和策略，目前可用数据较少。我们旨在研究十二指肠型FL的临床特征和结局。我们将十二指肠型FL定义为十二指肠受累，除肠道病变外无淋巴结或结外病变，经病理诊断为FL。我们回顾了2011年1月至2020年12月在神户市立医院组织、神户市立医疗中心总医院就诊的26例十二指肠型FL患者。特别是，患者被选择采用观察等待（WW）策略，并在我们机构每年约进行一次常规食管胃十二指肠镜检查进行随访。患者特征如下：中位年龄63.5岁（范围：42 - 78岁），性别（男性15例；女性11例），分期（I期，26例），分级（I级，26例）。关于治疗策略，23例患者被选择采用WW策略，3例患者接受了初始利妥昔单抗治疗。中位随访期为65.5个月（范围：0.2 - 109个月）。5年无进展生存率和5年总生存率分别为86.3%和100%。在23例被选择采用WW策略的患者中，6例出现自发完全缓解，14例病情稳定，3例病情进展，其中1例发生组织学转化。十二指肠型FL患者的WW策略可能是一种合适且安全的治疗选择。然而，在一些病例中记录到疾病进展，定期随访很重要。
