Current management of follicular lymphomas.
After decades of stagnation, the prognosis of patients with follicular lymphomas (FL) has changed substantially within the last few years due to new and effective therapeutic modalities. These include myeloablative therapy followed by autologous stem cell transplantation (ASCT) in younger patients in first remission, which showed a significant prolongation of remission duration in three prospective randomised trials while the impact on overall survival still needs to be determined. Adding the anti-CD 20 antibody Rituximab to conventional chemotherapy resulted in a significant increase in remission rate, remission duration and, in two of four currently available prospective randomised studies, even in a longer overall survival. A prolongation of remission duration was also seen when Rituximab was given as maintenance after cytoreductive therapy including Rituximab. Radio-immunotherapy (RIT) with radioisotopes coupled to monoclonal antibodies produced encouraging data in several phase II studies. New therapeutic perspectives have also emerged from increasing insights into the biology of the disease that unravel molecular targets for novel agents, some of which have entered clinical evaluation already.
Hiddemann
Wolfgang
W
Department of Internal Medicine III, University of Munich, Munich, Germany. wolfgang.hiddemann@med.uni-muenchen.de
Buske
Christian
C
Dreyling
Martin
M
Weigert
Oliver
O
Lenz
Georg
G
Unterhalt
Michael
M
D019264:Adoptive Transfer / Q000379:methods; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000912:Antibodies, Neoplasm / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007135:Immunoglobulin Variable Region / Q000276:immunology; D008224:Lymphoma, Follicular / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D019653:Myeloablative Agonists / Q000627:therapeutic use; D016499:Radioimmunotherapy; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D007135:Immunoglobulin Variable Region; D019653:Myeloablative Agonists