Department of Internal Medicine and Gastroenterology, Watanabe Internal Medicine Aoyama Clinic, Niigata-city 9502002, Japan.
World J Gastroenterol. 2023 Jun 21;29(23):3574-3594. doi: 10.3748/wjg.v29.i23.3574.
Follicular lymphoma (FL) is the most common low-grade lymphoma, and although nodal FL is highly responsive to treatment, the majority of patients relapse repeatedly, and the disease has been incurable with a poor prognosis. However, primary FL of the gastrointestinal tract has been increasingly detected in Japan, especially due to recent advances in small bowel endoscopy and increased opportunities for endoscopic examinations and endoscopic diagnosis. However, many cases are detected at an early stage, and the prognosis is good in many cases. In contrast, in Europe and the United States, gastrointestinal FL has long been considered to be present in 12%-24% of Stage-IV patients, and the number of advanced gastrointestinal cases is expected to increase. This editorial provides an overview of the recent therapeutic advances in nodal FL, including antibody-targeted therapy, bispecific antibody therapy, epigenetic modulation, and chimeric antigen receptor T-cell therapy, and reviews the latest therapeutic manuscripts published in the past year. Based on an understanding of the therapeutic advances in nodal FL, we also discuss future possibilities for gastroenterologists to treat gastrointestinal FL, especially in advanced cases.
滤泡性淋巴瘤（FL）是最常见的低度淋巴瘤，尽管结内 FL 对治疗高度敏感，但大多数患者会反复复发，且疾病无法治愈，预后较差。然而，近年来，日本越来越多地发现胃肠道原发性 FL，这主要归因于小肠内镜技术的进步以及内镜检查和诊断机会的增加。然而，许多病例在早期被发现，且在许多情况下预后良好。相比之下，在欧洲和美国，胃肠道 FL 长期以来被认为存在于 4 期患者的 12%-24%中，预计晚期胃肠道病例的数量将会增加。这篇社论概述了结内 FL 的最新治疗进展，包括抗体靶向治疗、双特异性抗体治疗、表观遗传调节和嵌合抗原受体 T 细胞治疗，并回顾了过去一年发表的最新治疗文献。基于对结内 FL 治疗进展的了解，我们还讨论了胃肠病学家治疗胃肠道 FL（尤其是晚期病例）的未来可能性。
