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Prognostic factors in follicular lymphomas Volume 11, issue 6, Novembre-Décembre 2005

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Authors
Centre Jean Bernard, 9 rue Beauverger, 72000 Le Mans, UPRES-EA3853, Faculté de médecine de Tours, 10 bd Tonnellé, BP 3223, 37032 Tours Cedex 2

With conventional treatments, the course of patients with follicular lymphoma was fatal in most cases. These treatments did not significantly modify the natural course of the disease. For the last ten years, innovative approaches have been proposed using interferon α, anti CD 20 monoclonal antibodies, radiolabeled or not, stem cell transplantation. The morbidity and the cost of these treatments are highly variable and the choice of a treatment must rely on objective parameters. Recently, several prognostic factors have been investigated in follicular lymphomas. Grade 3 follicular lymphomas with a poor prognosis have been individualized by pathologists. Using 5 parameters (age, number of nodal sites involved, Ann Arbor stage, serum LDH level, hemoglobin level), the Follicular Lymphoma International Prognostic Index allows to separate patients into three risk groups with significantly different hazard-ratios for death. Cytogenetic studies, and especially some additional abnormalities to the t(14;18) translocation, and more recently, molecular and gene profile analyses add to this prognostic information.