滤泡性淋巴瘤治疗进展

An update on management of follicular lymphoma

滤泡性淋巴瘤(FL)是成熟B淋巴细胞恶性增殖形成的淋巴瘤类型,其生物学行为和治疗具有很强的异质性。10%~15%患者可以等待观察,无需治疗;10%~20%的患者发生早期进展,整体生存时间明显缩短;30%~40%的患者可能发生组织学转化,需要强化治疗;迄今为止,大多数FL患者仍然不可治愈。FL的治疗应充分考虑患者耐受情况、肿瘤负荷及复发风险而采取个体化治疗,以改善患者的生活质量、延长患者生存为主要考量。本文主要总结了近年关于新型CD20单抗、PI3K抑制剂、EZH2抑制剂、PD-1/PD-L1抑制剂、CD19 CAR-T治疗等新药的安全性及有效性数据,为临床选择药物提供了循证医学证据。

Follicular lymphoma(FL)is a type of malignant tumor formed by the malignant proliferation of mature B lymphocytes,which has the characteristics of recurrent seizures,multi-line therapy endurance and long survival time.Its biological behavior and treatment is highly heterogeneous,10%-15%of patients do not need treatment,while 10%-20%of patients progress early with significantly reduced overall survival time,while 30%-40%of patients have histological transformation and need intensive treatment.Therefore,FL treatment should take full account of patient tolerance,tumor load and risk of recurrence and take individual treatment.Based on the safety and efficacy data of new drugs such as CD20 monoclonal anti-body,PI3K inhibitors,EZH2 inhibitors,PD-L1 inhibitors and CD19 CAR-T therapy reported by various international conferences in recent years,this paper provides evidence-based medical evidence for clinical selection of drugs.