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Inicio Medicina Clínica (English Edition) Follicular lymphoma: An update on diagnosis, prognosis, and management
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Vol. 157. Issue 9.
Pages 440-448 (November 2021)
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Vol. 157. Issue 9.
Pages 440-448 (November 2021)
Review
Follicular lymphoma: An update on diagnosis, prognosis, and management
Actualización en el diagnóstico, pronóstico y tratamiento del linfoma folicular
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Pablo Mozasa,
Corresponding author
mozas@clinic.cat

Corresponding author.
, Marc Soriguéb, Armando López-Guillermoa,c
a Servicio de Hematología, Hospital Clínic, Barcelona, Spain
b Servicio de Hematología, ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain
c Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Table 1. Recommended studies for the diagnosis, staging, prognosis and follow-up of FL.
Table 2. Most commonly used treatment regimens in FL.
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Abstract

Follicular lymphoma, the most common indolent lymphoma, originates from germinal centre B-cells of the lymphoid follicle, and is characterized by t(14;18). Clinical manifestations include the presence of lymphadenopathy, sometimes accompanied by constitutional symptoms or cytopenia. Diagnosis is established through the identification of a B-cell proliferation of nodular pattern in the lymph node biopsy. Upon staging with PET-CT and bone marrow biopsy, a significant proportion of patients do not need immediate treatment. When therapy is indicated, commonly used regimens include anti-CD20 immunotherapy with or without chemotherapy. Although overall survival for most patients is prolonged, relapses are very frequent, and early relapse and transformation to an aggressive lymphoma portend a much worse prognosis. New therapies are under development, which will most likely change outcomes for FL patients in the near future.

Keywords:
Follicular lymphoma
Diagnosis
Prognosis
Treatment
Immunochemotherapy
Resumen

El linfoma folicular, el linfoma indolente más frecuente, se origina en los linfocitos B del centro germinal del folículo linfoide y se caracteriza por la traslocación t(14;18). Clínicamente se manifiesta por la presencia de adenopatías, que pueden asociarse a síntomas constitucionales o citopenias. El diagnóstico se establece mediante la observación de una proliferación linfoide B de patrón nodular en la biopsia ganglionar, y la estadificación mediante un PET-TC y una biopsia de médula ósea. Una proporción significativa de pacientes no requiere tratamiento inmediato. Si lo requieren, suele estar basado en inmunoterapia anti-CD20 asociada o no a quimioterapia. A pesar de que la mayoría de pacientes presenta una supervivencia global prolongada, las recaídas son muy frecuentes, y la recaída precoz y la transformación a un linfoma agresivo confieren un mucho peor pronóstico. Se encuentran en desarrollo nuevos tratamientos que cambiarán las perspectivas de estos pacientes en un futuro próximo.

Palabras clave:
Linfoma folicular
Diagnóstico
Pronóstico
Tratamiento
Inmunoquimioterapia

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