Follicular lymphoma: Update on management and emerging therapies at the dawn of the new decade

Abstract

Follicular lymphoma is the most common indolent non-Hodgkin lymphoma. Survival has improved over the last several decades, mainly because of the incorporation of the anti-CD20 antibody rituximab into preexisting or rediscovered agents. The disease has a relapsing and remitting pattern, coupled with a risk of transformation into an aggressive lymphoma, and considered incurable for most patients. Nextgeneration sequencing technologies have increased our understanding of the biology and genetic landscape of the disease, identifying potential druggable targets for treatment. Current prognostic models cannot accurately identify patients at risk of early progression and despite the availability of treatment options for relapsed/refractory disease, rational treatment selection balancing disease control, efficacy with toxicity, and quality of life remain unmet needs. This review provides an overview of biology, prognostication, treatment options, and emerging therapies that provide valid grounds for optimism.

Emerging role of EZH2 in rheumatic diseases: A comprehensive review

“…M2 macrophages induce immune tolerance, promote neovascularization, and tumor cell proliferation and metastasis 39 . EZH2 inhibitors suppress M1 macrophage differentiation, polarization and inhibit TNF‐ɑ production 40–42 . Inhibiting EZH2 by GSK126 reduced formation of foam cells, which can attenuate progression of atherosclerosis 38 .…”

Low-Grade Primary Splenic CD10-Positive Small B-Cell Lymphoma/Follicular Lymphoma

“…Treatment of relapsed PSFL can also be modelled on nodal FL, where management is influenced by multiple, patient and disease related factors, including the interval between diagnosis and relapse, and documentation of histologic transformation. A growing number of signaling pathway-specific/non-chemotherapy agents and cellular therapies are becoming available for FL, which could change the course of this still incurable disease [ 60 , 61 ]. However, the applicability of these new strategies to PSFL is unknown, and probably dependent on further clarification of specific biological characteristics and pathogenic mechanisms.…”

Immune-Checkpoint Inhibitors in B-Cell Lymphoma

“…It is a neoplasm of germinal centre B cells, which display rearrangement of immunoglobulin (Ig) heavy and light chain genes and somatic hypermutation, and express common germinal centre markers such as BCL6, AID and CD10 [10][11][12]. FL generally presents an indolent clinical course, with median overall survival (OS) of more than 15 years [10,13]. However, about 20% of patients relapse during the first 2 years after treatment, and others evolve into transformed-FL (t-FL), a much more aggressive subtype [10].…”