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Natural history of follicular grade 3 non-Hodgkin's lymphoma

Bierman, Philip J

doi: 10.1097/CCO.0b013e3282c9ad78
Lymphoma
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Purpose of review Follicular lymphoma grade 3 is recognized as a distinct entity in the World Health Organization classification of lymphomas. There is confusion regarding the natural history of these lymphomas, because some studies indicate an indolent behavior and others show more aggressive behavior. This review examines the biological and clinical characteristics of follicular lymphoma grade 3 and compares these characteristics with other lymphomas.

Recent findings Several reports suggest that follicular lymphoma grade 3 has molecular and genetic characteristics that distinguish these lymphomas from other grades of follicular lymphoma. These characteristics are often more common in patients with diffuse large B-cell lymphoma than follicular lymphoma. It is impossible to make firm recommendations on management because prospective trials are lacking. Nevertheless, recent studies have demonstrated that follicular lymphoma grade 3 patients treated with anthracycline-based therapy have similar outcomes to patients with diffuse large B-cell lymphoma.

Summary Patients with follicular lymphoma grade 3 should be treated with curative intent. They should receive aggressive anthracycline-based therapy combined with rituximab, which is identical to therapy used for patients with diffuse large B-cell lymphoma.

Department of Internal Medicine, Section of Oncology/Hematology, University of Nebraska Medical Center, Omaha, Nebraska, USA

Correspondence to Philip J. Bierman, MD, Department of Internal Medicine, Section of Oncology/Hematology, University of Nebraska Medical Center, 987680 Nebraska Medical Center, Omaha, NE 68198-7680, USA Tel: +1 402 559 5520; fax: +1 402 559 6520; e-mail: pjbierma@unmc.edu

© 2007 Lippincott Williams & Wilkins, Inc.