Follicular lymphoma in children and adolescents: clinical, diagnostic and therapeutic features
https://doi.org/10.17650/1818-8346-2023-18-3-18-25
Abstract
Ffollicular lymphoma (FL) is one of the most common non-Hodgkin’s lymphomas in adults, while it is a diagnosis of exclusion in adolescents and children. Clinical manifestations of FL in children are represented by long-term asymptomatic lymphadenopathy, less commonly by extranodal areas involvement. treatment standards for FL in children have not been developed and may vary from observational tactics (with the radical resection of a single focus during a biopsy) to the use of radiation therapy and polychemotherapy. Pediatric type follicular lymphoma was first identified as a distinct variant in 2008 in the world Health organization classification of hematopoietic and lymphoid tissue tumors. Clinical, morphological (cytological type 3A), Immunohistochemical (absence of bcl2 expression in the center of the follicle) and cytogenetic (absence of t(14;18)(q32;q21)) features served as the reason for separation into an independent nosological variant. Despite the term “pediatric”, cases of pediatric type FL have been described in adults over 30 years of age. Most often, the disease is diagnosed in the early stages (I, II) and is characterized by a favorable prognosis. In children and adolescents, FL occurs not only of the pediatric type. we present a clinical case of a typical “adult” type FL (grade 1–2) in a 17-year-old patient. the cHop therapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone) with rituximab resulted in a complete remission, which lasted more than 2.5 years.
Keywords
About the Authors
T. T. ValievRussian Federation
Timur Teymurazovich Valiev
115478
23 Kashirskoe Shosse
119991
Build. 2, 8 Trubetskaya St.
Moscow
A. S. Volkova
Russian Federation
115478
23 Kashirskoe Shosse
Moscow
M. A. Postoykina
Russian Federation
690078
27 Prospekt Ostryakova
Vladivostok
D. S. Abramov
Russian Federation
117198
1 Samory Mashela St.
Moscow
A. R. Karibova
Russian Federation
690078
27 Prospekt Ostryakova
Vladivostok
A. A. Odzharova
Russian Federation
115478
23 Kashirskoe Shosse
Moscow
Yu. E. Ryabukhina
Russian Federation
143081
111 1st Uspenskoe Shosse
Lapino, Moscow region
P. A. Zeynalova
Russian Federation
119991
Build. 2, 8 Trubetskaya St.
143081
111 1st Uspenskoe Shosse
Moscow
Lapino, Moscow region
References
1. Liu Q., Salaverria I., Pittaluga S. et al. Follicular lymphomas in children and young adults: a comparison of the pediatric variant with usual follicular lymphoma. Am J Surg Pathol 2013;37(3): 333–43. DOI: 10.1097/PAS.0b013e31826b9b57
2. Green M.R. Chromatin modifying gene mutations in follicular lymphoma. Blood 2018;131(6):595–604. DOI: 10.1182/blood-2017-08-737361
3. Tumyan G.S. Follicular lymphoma: current trends and my choice. Klinicheskaya onkogematologiya = Clinical Oncohematology 2013;6(1):20–33. (In Russ.).
4. Tumyan G.S., Leontieva A.A., Falaleeva N.A. et al. Follicular lymphoma: 10 years of therapy. Klinicheskaya onkogematologiya = Clinical Oncohematology 2012;(3). (In Russ.).
5. Fischer T., Zing N.P.C., Chiattone C.S. et al. Transformed follicular lymphoma. Ann Hematol 2018;97(1):17–29. DOI: 10.1007/s00277-017-3151-2
6. Kovrigina A.M., Plastinina L.V., Kravchenko S.K. et al. Diagnosis of pediatric type follicular lymphoma in young adults (own data). Klinicheskaya onkogematologiya = Clinical Oncohematology 2017;10(1):52–60. (In Russ.).
7. Pugh T.J., Ballonoff A., Newman F., Rabinovitch R. Improved survival in patients with early stage lowgrade follicular lymphoma treated with radiation. A Surveillance, Epidemiology, and End Results database analysis. Cancer 2010;116(16):3843–51. DOI: 10.1002/cncr.25149
8. Ardeshna K.M., Smith P., Norton A. et al. Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advancedstage nonHodgkin lymphoma: a randomised controlled trial. Lancet 2003;362(9383):516–22. DOI: 10.1016/s0140-6736(03)14110-4
9. Subramanian J., Cavenagh J., Desai B., Jacobs I. Rituximab in the treatment of follicular lymphoma: the future of biosimilars in the evolving therapeutic landscape. Cancer Manag Res 2017;9:131–140. DOI: 10.2147/CMAR.S120589
10. Mondello P., Steiner N., Willenbacher W. et al. Bendamustine plus rituximab versus RCHOP as firstline treatment for patients with follicular lymphoma Grade 3A: evidence from a multicenter, retrospective study. Oncologist 2018;23(4):454–60. DOI: 10.1634/theoncologist.2017-0037
11. Oschlies I., Salaverria I., Mahn F. et al. Pediatric follicular lymphoma – a clinicopathological study of a populationbased series of patients treated within the NonHodgkin’s Lymphoma – Berlin–Frankfurt–Munster (NHLBFM) multicenter trials. Haematologica 2010;95(2):253–9. DOI: 10.3324/haematol.2009.013177
12. Louissaint A.Jr, Schafernak K.T., Geyer J.T. et al. Pediatrictype nodal follicular lymphoma: a biologically distinct lymphoma with frequent MAPK pathway mutations. Blood 2016;128(8):1093–100. DOI: 10.1182/blood-2015-12-682591
13. Attarbaschi A., Beishuizen A., Mann G. et al. European Intergroup for Childhood NonHodgkin Lymphoma (EICNHL) and the international BerlinFrankfurtMünster (iBFM) Study Group. Children and adolescents with follicular lymphoma have an excellent prognosis with either limited chemotherapy or with a “Watch and wait” strategy after complete resection. Ann Hematol 2013;92(11):1537–41. DOI: 10.1007/s00277-013-1785-2
14. Du X.Y., Huang R., Cao L. et al. Clinical observation of five pediatrictype follicular lymphoma in adult. Zhonghua Xue Ye Xue Za Zhi 2019;40(5):393–7. DOI: 10.3760/cma.j.issn.0253-2727.2019.05.009
15. Verma A., Pan Z. Pediatrictype follicular lymphoma. Hum Pathol Rep 2022;27. DOI: 10.1016/j.hpr.2022.300590
Review
For citations:
Valiev T.T., Volkova A.S., Postoykina M.A., Abramov D.S., Karibova A.R., Odzharova A.A., Ryabukhina Yu.E., Zeynalova P.A. Follicular lymphoma in children and adolescents: clinical, diagnostic and therapeutic features. Oncohematology. 2023;18(3):18-25. https://doi.org/10.17650/1818-8346-2023-18-3-18-25