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18 - Follicular lymphomas

Published online by Cambridge University Press:  10 January 2011

By
Francisco J. Hernandez-Ilizaliturri  and
Myron S. Czuczman
Edited by
Susan O'Brien ,
Julie M. Vose  and
Hagop M. Kantarjian
Francisco J. Hernandez-Ilizaliturri
Affiliation:
Departments of Medicine and Immunology, Roswell Park Institute, Buffalo, NY, USA
Myron S. Czuczman
Affiliation:
Departments of Medicine and Immunology, Roswell Park Institute, Buffalo, NY, USA
Susan O'Brien
Affiliation:
University of Texas/MD Anderson Cancer Center, Houston
Julie M. Vose
Affiliation:
University of Nebraska Medical Center, Omaha
Hagop M. Kantarjian
Affiliation:
University of Texas/MD Anderson Cancer Center, Houston
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Summary

Introduction

Follicular lymphoma (FL) is the most common type of indolent B-cell lymphoma diagnosed in the United States. A better understanding of the biology of disease and the development of novel targeted agents are challenging prior dogmatic concepts regarding the standard therapeutic approach to FL.

In recent years, the lymphoma field has seen significant progress with respect to the identification of clinical, tumor-associated, and host-associated prognostic factors, as well as the development of novel functional imaging (e.g., positron emission tomography [PET] scans). Improvements in molecular diagnostics allow a clearer distinction between various lymphoma subtypes. Perhaps the single most important advance has been the development and integration of monoclonal antibodies (mAbs) into the treatment of B-cell lymphoma which has resulted in a steady improvement in progression-free survival (PFS) and overall survival (OS) of patients. This chapter summarizes the advances achieved in the last two decades that have led to the current approach and management of patients with FL.

Pathogenesis of FL

As technology and its applications have improved over the last two decades, there has been a parallel improvement in our understanding of the molecular mechanisms responsible not only for the development of FL, but also to explain its clinical heterogeneity. Ontologically, FL arises from germinal B cells usually as a result of deregulation in the apoptotic machinery. FL was one of the first lymphomas in which a molecular defect was defined.

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Chapter
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Management of Hematologic Malignancies , pp. 338 - 366
Publisher: Cambridge University Press
Print publication year: 2010

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