The diagnostic and therapeutic challenges of Grade 3B follicular lymphoma

Br J Haematol. 2021 Oct;195(1):15-24. doi: 10.1111/bjh.17404. Epub 2021 Mar 11.

Abstract

Grade 3B follicular lymphoma (G3B FL) is rare, accounting for only 5-10% of FLs. Not only has it been routinely excluded from clinical trials, but data published on diagnosis, outcomes, choice of therapies and role of imaging are conflicting. With the advent of increasingly diverse treatment options for low-grade (G1-3A) FL, and the molecular subcategorisation of high-grade B-cell lymphomas, characterisation and treatment of G3B FL is ever more important as extrapolation of data becomes more difficult. New data have emerged exploring unique genetic characteristics, specific features on positron emission tomography imaging, choice of therapy, and outcomes of G3B FL in the current era. The present review will summarise and appraise these new data, and offer recommendations based on current evidence.

Keywords: lymphoid malignancies; lymphoma; lymphoproliferative disease; non-Hodgkin lymphoma.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis
  • Chromosome Aberrations
  • Chromosomes, Human, Pair 14 / ultrastructure
  • Chromosomes, Human, Pair 18 / ultrastructure
  • Female
  • Gene Expression Regulation, Neoplastic
  • Genetic Heterogeneity
  • Germinal Center / pathology
  • Humans
  • Lymphoma, Follicular / chemistry
  • Lymphoma, Follicular / diagnostic imaging
  • Lymphoma, Follicular / drug therapy
  • Lymphoma, Follicular / pathology*
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Pathology, Molecular
  • Positron Emission Tomography Computed Tomography
  • Prognosis
  • Protein Biosynthesis
  • Rituximab / therapeutic use
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Rituximab