IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Ádám Jóna, Evelin Kiss, Árpád Illés
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引用次数: 0

摘要

滤泡性淋巴瘤(FL)是一种临床病程多变、极少治愈的B细胞恶性肿瘤。虽然 FL 通常可以治疗,但其特点是时而缓解、时而复发,临床表现也千差万别。利妥昔单抗彻底改变了 FL 的治疗,在过去二十年中显著提高了患者的总生存率。风险评估通常依赖于组织学分级、肿瘤负荷和滤泡性淋巴瘤国际预后指数,其中包括年龄、血红蛋白水平和安娜堡分期等因素。然而,这些指数在全面反映FL的临床变异性方面存在局限性。有些患者的病情较轻,长期不需要治疗,而有些患者则表现为对标准疗法有抵抗力的侵袭性疾病。本综述探讨了 FL 的各种预后因素,包括 FLIPI、FLIPI2、PRIMA-PI 和 m7-FLIPI。FLIPI 基于五个风险因素,将患者分为低危、中危和高危组。FLIPI2 纳入了 beta2-微球蛋白和最大受累结节的最长直径,从而改善了预后。PRIMA-PI 是专为接受含利妥昔单抗方案的患者设计的,它使用 beta2-微球蛋白、骨髓受累情况和最大受累结节的最长直径。m7-FLIPI 将突变状态与 FLIPI2 参数相结合,进一步完善了风险分层。综述还讨论了作为预后因素的临床参数,如 PET/CT 最大标准化摄取值和淋巴细胞/单核细胞比值。高 SUVmax 和低淋巴细胞/单核细胞比值可识别高危患者。虽然 FL 仍无法治愈,但免疫化疗和靶向治疗的进步已改善了预后。本综述全面概述了 FL 的预后工具,强调了风险分层对个性化治疗策略的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostication of Follicular Lymphoma: A Review of Prognostic Scores and Factors.

Follicular lymphoma (FL) is an indolent, rarely curable B-cell malignancy with a heterogeneous clinical course. While generally treatable, FL is characterized by remissions and relapses, and its clinical presentation varies widely. Rituximab has revolutionized FL treatment, significantly improving overall survival over the past two decades. Risk assessment typically relies on histological grade, tumor burden, and the Follicular Lymphoma International Prognostic Index, which incorporates factors like age, hemoglobin level, and Ann Arbor stage. However, these indices have limitations in fully capturing the clinical variability of FL. Some patients experience indolent disease for extended periods without requiring treatment, while others present with aggressive forms resistant to standard therapies. This review examines various prognostic factors in FL, including the FLIPI, FLIPI2, PRIMA-PI, and m7-FLIPI. The FLIPI, based on five risk factors, stratifies patients into low-, intermediate-, and high-risk groups. The FLIPI2 incorporates beta2-microglobulin and the longest diameter of the largest involved node, offering improved prognostication. The PRIMA-PI, designed for patients receiving rituximab-containing regimens, uses beta2-microglobulin, bone marrow involvement, and the longest diameter of the largest involved node. The m7-FLIPI integrates mutational status with FLIPI2 parameters, further refining risk stratification. The review also discusses clinical parameters like maximum standardized uptake value on PET/CT and lymphocyte/monocyte ratio as prognostic factors. A high SUVmax and low lymphocyte/monocyte ratio identify high-risk patients. While FL remains incurable, advances in immunochemotherapy and targeted therapies have improved outcomes. This review provides a comprehensive overview of prognostic tools in FL, emphasizing the importance of risk stratification for personalized treatment strategies.

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来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
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