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Current prognostic and predictive factors in follicular lymphoma

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Abstract

Follicular lymphoma (FL) is generally considered an indolent disorder. With modern day treatments, long remissions are often achieved both in the front-line and relapsed setting. However, a subset of patients has a more aggressive course and a worse outcome. Their identification is the main purpose of modern day prognostic tools. In this review, we attempt to summarize the evidence concerning prognostic and predictive factors in FL, including (1) pre-treatment factors, from baseline clinical characteristics and imaging tests to histological grade, the microenvironment and genomic abnormalities; (2) post-treatment factors, i.e., depth of response, measured both by imaging tests and minimal residual disease; (3) factors at relapse and duration of response; and (4) prognostic factors in histological transformation. We conclude that, despite the existence of numerous tools, the availability of some of them is still limited; they generally suffer from notable downsides, and most have unproven predictive value, thus having scarce bearing on the choice of regimen at present. However, with the technological and scientific developments of the last few years, the potential for these prognostic factors is promising, particularly in combination, which will probably, in time, help guide therapeutic decisions.

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Acknowledgments

The authors wish to thank Lurdes Zamora, Elias Vaattovaara, and Milos Miljkovic for their critical review of the manuscript; to Montserrat Cortés for her aid with the sections about image testing; and to Dr. Harumi Kato for sharing unpublished data from his cohort.

Funding

This work was supported in part by the following grants: RD12/0036/0029 del Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Red Temática de Investigación Cooperativa en Cáncer (RTICC, FEDER); SGR225 (GRE) Generalitat de Catalunya; ayuda económica de la Fundació Internacional Josep Carreras y de la fundación La Caixa.

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  1. Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Ctra. Canyet, 08916, Badalona, Spain

    Marc Sorigue & Juan-Manuel Sancho

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MS and JMS wrote and edited the manuscript.

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Sorigue, M., Sancho, JM. Current prognostic and predictive factors in follicular lymphoma. Ann Hematol 97, 209–227 (2018). https://doi.org/10.1007/s00277-017-3154-z

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