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Prognostic Factors in Follicular Lymphoma

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Abstract

Follicular lymphoma (FL) is the most common indolent lymphoma. The majority of patients achieve a long-lasting remission with first-line induction therapy and have a good prognosis with median survival in excess of 20 years. However, approximately 20% exhibit early progression and have a poor prognosis. These are the patients who may benefit from novel treatment approaches. The challenge is in identifying them before progression. This chapter discusses current and developing approaches to define prognosis in follicular lymphoma. In current practice, prognostic indices based on readily available clinical information such as the Follicular Lymphoma International Prognostic Index (FLIPI) remain the most widely used prognostic tools. Developing approaches include measurement of total metabolic tumor volume (TMTV) using positron emission tomography (PET), clinicogenetic indices which integrate information about common genetic lesions in follicular lymphoma, and measures of the tumor microenvironment. The prognostic role of PET performed after induction treatment is now well defined, and evidence for this and future directions for research are discussed. The review is divided into two parts, the first focusing on clinical prognostic factors both at diagnosis and after treatment and the second discussing approaches based on emerging understanding of disease biology.

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Johnston, A., Trotman, J. (2020). Prognostic Factors in Follicular Lymphoma. In: Fowler, N. (eds) Follicular Lymphoma. Springer, Cham. https://doi.org/10.1007/978-3-030-26211-2_5

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