Transformation of follicular lymphoma

Lossos, Izidore S.; Gascoyne, Randy D.

doi:10.1016/j.beha.2011.02.006

Cited by 152 publications

(128 citation statements)

References 119 publications

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“…The patients in these series were not treated initially with rituximab, however, and it is currently unclear whether rituximab may decrease the incidence of transformation and/or change its prognosis. The pathology of transformed FL (TFL) most often resembles DLBCL, but other histologies may be observed that overlap Burkitt lymphoma and DLBCL (so-called gray-zone lymphomas) (96). TFL shares a distinct gene expression profile and immunophenotype with the original FL (97).…”

Section: Complex Pathways Of Progression and Transformationmentioning

confidence: 99%

Pathogenesis of follicular lymphoma

Lackraj

Goswami

Kridel

2018

Best Practice & Research Clinical Haematology

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The hallmark t(14;18)(q32;q21) in follicular lymphoma (FL) results in constitutive overexpression of the BCL2 protein, allowing B cells to abrogate the default germinal center apoptotic program. Most tumors are characterized by recurrent secondary genetic alterations including genomic gains, losses, and mutations, some providing a growth advantage, including alterations in MLL2, EPHA7, TNFRSF14, and EZH2. The sequence in which these events occur and how they contribute to progression and ultimately to transformation is unclear. Lastly, crosstalk between neoplastic B cells and non-neoplastic immune and stromal cells in the microenvironment plays an important role in sustaining tumor cell growth, cultivating immune privilege, and promoting transformation.

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Section: Complex Pathways Of Progression and Transformationmentioning

confidence: 99%

Pathogenesis of follicular lymphoma

Lackraj

Goswami

Kridel

2018

Best Practice & Research Clinical Haematology

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“…Moreover, it enables accurate detection of lymphoma transformation due to the significantly increased FDG uptake in histologically transformed areas [22]. Furthermore, it has to be stressed that, among all the i-NHL subtypes, FL has a higher risk of secondary tumours or transformation in a more aggressive lymphoma, most commonly diffuse large B-cell lymphoma [23].…”

Section: Imaging Monitoring and Wwmentioning

confidence: 99%

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

et al. 2017

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The indolent non-Hodgkin lymphomas (i-NHLs) are characterised by 'indolent' clinical behaviour with slow growth and prolonged natural history. The watchful waiting (WW) strategy is a frequently employed treatment option in these patients. This implies a strict monitoring by imaging examinations, including 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) and CT. A major concern is radiation exposure due to regularly monitoring by conventional imaging procedures. Several studies have demonstrated the reliability of whole-body magnetic resonance imaging (WB-MRI) for lymphoma staging. WB-MRI could be useful for active surveillance in iNHLs providing the suspect of disease progression that can be then confirmed by additional diagnostic procedures, including 18F-FDG-PET/CT. The directive 2013/59 by the European Union claims that if a radiation-free imaging technique allows obtaining the same diagnostic results, it should be invariably used.In this setting, WB-MRI may be considered a reasonable option in i-NHLs under WW, replacing imaging modalities that cause exposure to ionising radiations. This will help to reduce the cancer risk in i-NHL patients for whom chemo-/radiotherapy remain the usual treatment options following the usually long WW phase. The scientific community should raise the awareness of the risk of ionising radiations in i-NHLs and the emphasise the need for establishing the proper place of WB-MRI in lymphoma imaging. Key Points• Watchful waiting is a reasonable option in patients with indolent non-Hodgkin lymphomas.• Imaging is crucial to monitor patients with indolent nonHodgkin lymphomas.• CT and 18 F-FDG-PET/CT are commonly used, implying a substantial radiation exposure.• WB-MRI is highly reliable in lymphoma staging.• WB-MRI may be considered to monitor indolent nonHodgkin lymphomas under watchful waiting.

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“…Overall, studies conducted suggest a cumulative rate of transformation FL to DLBCL of about 3% per year [4]. The transformed disease is usually incurable and has shorter disease free survival.…”

Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Transformed Follicular Lymphoma.

Nkosi¹

2015

J Clin Case Rep

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Transformation of follicular lymphoma (FL) to Diffuse Large B-Cell Lymphoma (DLBCL) occurs commonly is and associated with a rapidly progressive clinical course that is refractory to treatment and a short survival. The clinical presentation of this transformed disease is variable. We here report a 65 years old man with an atypical presentation of transformed FL. He initially presented with symptoms and clinical signs consistent with Multiple myeloma. His bone marrow biopsy result revealed plasma cell infiltration (CD 138+, CD56-) throughout the marrow. He had a rapid progressive worsening of his condition; he developed liver and renal failure. His imaging studies revealed diffuse lymphadenopathy, an excisional lymph node biopsy done showed FL which had transformed into DLBCL with prominent plasma cell differentiation. He was treated with of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone) with overall good response but has currently relapsed.

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Transformation of follicular lymphoma

Cited by 152 publications

References 119 publications

Pathogenesis of follicular lymphoma

Pathogenesis of follicular lymphoma

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

Atypical Presentation of Transformed Follicular Lymphoma.

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