Clinical and genetic characteristics of follicular lymphoma with bulky disease
10.3969/j.issn.1006-5725.2025.10.011
- VernacularTitle:大包块滤泡性淋巴瘤的临床和基因特征
- Author:
Tianyuan XU
1
;
Ruichi LI
1
;
Rui SUN
1
;
Nan WANG
1
;
Shu CHENG
1
;
Li WANG
1
;
Pengpeng XU
1
;
Weili ZHAO
1
;
Zhong ZHENG
1
Author Information
1. 上海血液学研究所,组学与疾病国家重点实验室,转化医学国家重大科技基础设施(上海),上海交通大学医学院附属瑞金医院(上海 200025)
- Publication Type:Journal Article
- Keywords:
follicular lymphoma;
bulky disease;
clinicopathologic characteristic;
gene mutation;
prognostic analysis
- From:
The Journal of Practical Medicine
2025;41(10):1502-1508
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the characteristics and prognosis of follicular lymphoma(FL)with bulky disease under rituximab-based first-line treatment.Methods A retrospective analysis was conducted on 525 FL patients diagnosed between September 2009 and September 2021 who received rituximab as a first-line treat-ment[342 patients received rituximab combined with chemotherapy(R-chemo),183 patients received rituximab plus lenalidomide(R2)].The clinicopathologic characteristics,gene mutations,and prognosis of bulky FL patients were analyzed.Results Compared to non-bulky FL patients,bulky FL patients had a significantly higher proportion of lymph node≥5 sites,≥2 extranodal involvement,bone marrow involvement,elevated LDH,and a higher proportion in the high-risk group of FLIPI1 and FLIPI2.Gene sequencing revealed a significantly higher mutation rate of ZNF608 in bulky FL patients compared to non-bulky FL patients.In patients receiving R-chemo as the first-line treatment,there was no significant difference in progression-free survival(PFS)and overall survival(OS)between bulky and non-bulky FL patients.However,in patients treated with R2,the PFS and OS of bulky FL patients was significantly shorter.Conclusions Bulky FL patients compared to non-bulky FL patients have a significantly higher proportion of high-risk baseline characteristics.For bulky FL at diagnosis,chemo-free regimens require further exploration on the basis of R2.
