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1、LOGOFollicular LymphomaContentsincidence and epidemiologydiagnosis and molecular biologystaging and risk assessmenttreatmentfollow-up and long-term implicationsFLSites and enrollment by region.Follicular lymphoma is the second most common subtype of lymphoma (although its incidence may be lower in s
2、ome parts of the world such as Asia) and represents about 20% to 25% of cases of non-Hodgkin lymphomas in the U.S. and Europe.Incidence and EpidemiologyDiagnosis and Molecular biologyHistological and pathologicalImmunohistologic findingsGENETIC ABNORMALITIESGrading of follicular lymphomaAnnals of On
3、cology Advance AccessCD19+ 、CD20+ 、CD79a+、CD10+、Bcl6+BCL2 rearrangement、t( 14；18)、t( 8；14)Histological and pathologicalGrading of follicular lymphomaArchitectural Patterns in FollicularSpectrum of Follicle MorphologyImmunoarchitectural Patterns of Follicualr lymphoma 1.Describe contents for a Chart
4、- Description of the companys sub contents - Description of the companys sub contents2.Describe contents for a Chart - Description of the companys sub contents - Description of the companys sub contentsImmunohistologic findingsIHCGENETIC ABNORMALITIESGENETIC ABNORMALITIESThemeGallery is a Design Dig
5、ital Content & Contents mall developed by Guild Design Inc.Guild Design is one of aligned company with Microsoft Ltd, and we develop and provide the design templates for Office 97, 2000, and XP.GENETIC ABNORMALITIESA model of the FL microenvironment.Click to add TextClick to add TextClick to add Tex
6、tClick to add TextClick to add TextClick to add TextClick to add TextGENETIC ABNORMALITIESBCL2 mutations correlate with transformation risk and disease-specific death in FL.Click to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextGENETIC
7、ABNORMALITIESGraphic summary of common genetic lesions in follicular lymphomaClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextBCL2 mutations in FL correlate with activation-Induced cytidine deaminase expression and frequently alte
8、r the amino acid sequence of the protein.Mutations in the BCL2 coding sequence at diagnosis are associated with shortened time to transformation andEarlier death due to lymphoma.Description of the contentsDescription of the contentsGENETIC ABNORMALITIESClick to add TextClick to add TextClick to add
9、TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add Text “ “ThemeGallery is a Design Digital Content & Contents mall ThemeGallery is a Design Digital Content & Contents mall develope
10、d by Guild Design Inc.”developed by Guild Design Inc.”Staging and Risk AssessmentA New Prognostic Index for FLDescription of the companys sub contentsDescription of the companys sub contentsDescription of the companys sub contentsContentContentTitleTitleContentContentTitleTitleClick to add TextClick
11、 to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextStaging and Risk AssessmentFLIPI-2 better than FLIPI-1?Stage IIIStages IIIIVInduction therapyConsolid
12、ation/MaintenanceRelapsed diseaseTreatmentFirst lineStage IIIStage IIIIn stage III patients with large tumour burden or adverseprognostic features, systemic therapy as indicated for advancedstages should be applied; a radiation consolidation may be considered depending on tumour location and expecte
13、d side-effects.In the small proportion of patients with limited non-bulky stages I-II, radiotherapy is the preferred treatment having acurative potential, whereas the 22 Gy schedule is inferior and is merely palliative. In selected cases, watchful waiting or rituximab monotherapy maybe considered to
14、 avoid the side-effects of radiation.Stages IIIIV Treatment IndicationTREATbulky diseaseB symptomsascites, pleural effusionvital organ compressionhaematopoietic impairmentrapid lymphoma progressionCriteria for delaying treatment in FLWatchful waitingStages IIIIVImmuno-Immuno-chemotherapychemotherapy
15、R-CHOPR-CVPR-FCR-FMR-BImmunotherapyImmunotherapyRituximabRadio-Radio-immunotherapyimmunotherapy131I-tositumomabFirst lineWatchful waitingClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to a
16、dd TextClick to add TextClick to add TextClick to add TextDescription of the contentsDescription of the contentsDescription of the contentsSimplified summary of current and emerging treatment options Simplified summary of current and emerging treatment options for follicular lymphoma.for follicular
17、lymphoma.Treatmentconsolidation/maintenanceRituximab maintenance for 2 yearsRadio-immunotherapy consolidation. .ASCT利妥昔单抗维持治疗可作为高危和高肿瘤负荷患者选择利妥昔单抗维持治疗可作为高危和高肿瘤负荷患者选择00 01 02 03 04 05 06 07 00 01 02 03 04 05 06 07 50%70%160%230%100%150%380%300%YearClinical trials examining rituximab maintenance therap
18、yClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextCTX cytotoxic chemotherapy, ERG Evidence Review Group, HR CTX cytotoxic chemot
19、herapy, ERG Evidence Review Group, HR hazard ratio, NE not estimable, NS not stated, PFS progression-hazard ratio, NE not estimable, NS not stated, PFS progression-free survival, RTX rituximabfree survival, RTX rituximabKey outcomes of the PRIMA trialClick to add TextClick to add TextClick to add Te
20、xtClick to add TextClick to add TextClick to add TextTreatment-SummaryStep 1Step 2Step 3A repeated biopsy is strongly recommended.Observation is an accepted approach in asymptomatic patients with low tumour burden.Salvage treatmentRelapsed DiseaseStep 3Step 4Better OS50%70%160%YearEORTC 2098170%160%
21、230%100%150%300%YearEORTC 20981YearGerman Low Grade Lymphoma Study Group (GLSG)YearASCT for Relapsed FLYearASCT for Relapsed FLYearRESORT (Rituximab Extended Schedule or Re-Treatment Trial)In lowtumor burden FL, a re-treatment strategy uses less rituximab while providing disease control comparable t
22、o that achieved with a maintenance strategy.Click to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextGENETIC ABNORMALITIESGraphic summary of common genetic lesions in follicular lymphomaClick to add TextClick to add TextClick to add TextC
23、lick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextClick to add TextDescription of the contentsDescription of the contentsDescription of the contentsSimplified summary of current and emerging treatment options Simplified summary of current and emerging treatment options for follicular lymphoma.for follicular lymphoma.New TherapyFollow-up and Long-term implicationsResponse Evaluation ent Title淋巴瘤疗效评定（包括淋巴瘤疗效评定（包括PETPET）LOGO
