Follicular lymphoma: Nature Reviews. Disease Primers

Antonino Carbone, Sandrine Roulland, Annunziata Gloghini, Anas Younes, Gottfried von Keudell, Armando López-Guillermo, Jude Fitzgibbon

Research output: Contribution to journalArticle

Abstract

Follicular lymphoma (FL) is a systemic neoplasm of the lymphoid tissue displaying germinal centre (GC) B cell differentiation. FL represents ~5% of all haematological neoplasms and ~20-25% of all new non-Hodgkin lymphoma diagnoses in western countries. Tumorigenesis starts in precursor B cells and becomes full-blown tumour when the cells reach the GC maturation step. FL is preceded by an asymptomatic preclinical phase in which premalignant B cells carrying a t(14;18) chromosomal translocation accumulate additional genetic alterations, although not all of these cells progress to the tumour phase. FL is an indolent lymphoma with largely favourable outcomes, although a fraction of patients is at risk of disease progression and adverse outcomes. Outcomes for FL in the rituximab era are encouraging, with ~80% of patients having an overall survival of >10 years. Patients with relapsed FL have a wide range of treatment options, including several chemoimmunotherapy regimens, phosphoinositide 3-kinase inhibitors, and lenalidomide plus rituximab. Promising new treatment approaches include epigenetic therapeutics and immune approaches such as chimeric antigen receptor T cell therapy. The identification of patients at high risk who require alternative therapies to the current standard of care is a growing need that will help direct clinical trial research. This Primer discusses the epidemiology of FL, its molecular and cellular pathogenesis and its diagnosis, classification and treatment.
Original languageEnglish
JournalNature Reviews Disease Primers
Volume5
Issue number1
DOIs
Publication statusPublished - 2019

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    Carbone, A., Roulland, S., Gloghini, A., Younes, A., von Keudell, G., López-Guillermo, A., & Fitzgibbon, J. (2019). Follicular lymphoma: Nature Reviews. Disease Primers. Nature Reviews Disease Primers, 5(1). https://doi.org/10.1038/s41572-019-0132-x