Fukuhara Noriko
Department of Hematology, Tohoku University Hospital.
Rinsho Ketsueki. 2023;64(9):1019-1025. doi: 10.11406/rinketsu.64.1019.
Follicular lymphoma (FL) is the most common indolent lymphoma, benefits from anti-CD20 monoclonal antibody therapy, and has a median overall survival of over 15 years. However, it remains incurable in the majority of patients despite the current standard therapeutic strategy. For advanced-stage cases with a low tumor burden, watchful waiting remains the standard treatment. The optimal timing of rituximab monotherapy is a clinical question. For advanced-stage cases with a high tumor burden, the standard of care includes anti-CD20 monoclonal antibody and chemotherapy, followed by maintenance therapy for 2 years in responding cases. The significance of maintenance therapy after bendamustine administration has not been confirmed. Even within the early relapse group, histological transformation is the most important prognostic factor. For refractory FL, anti-CD19 chimeric antigen receptor T-cell therapy and CD20/CD3-bispecific antibodies have shown promising results. This review presents the current FL treatment strategy and prognostic factors.
滤泡性淋巴瘤（FL）是最常见的惰性淋巴瘤，受益于抗CD20单克隆抗体治疗，中位总生存期超过15年。然而，尽管有当前的标准治疗策略，但大多数患者仍无法治愈。对于肿瘤负荷低的晚期病例，观察等待仍是标准治疗方法。利妥昔单抗单药治疗的最佳时机是一个临床问题。对于肿瘤负荷高的晚期病例，标准治疗包括抗CD20单克隆抗体和化疗，对有反应的病例随后进行2年的维持治疗。苯达莫司汀给药后维持治疗的意义尚未得到证实。即使在早期复发组中，组织学转化也是最重要的预后因素。对于难治性FL，抗CD19嵌合抗原受体T细胞疗法和CD20/CD3双特异性抗体已显示出有前景的结果。本综述介绍了当前FL的治疗策略和预后因素。
