Follicular lymphoma natural history, complications and prognosis: Difference between revisions
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{{CMG}}; {{AE}} {{AS}} | {{CMG}}; {{AE}} {{AS}} | ||
==Overview== | ==Overview== | ||
Follicular lymphoma presents in the age group of 60-65 with systemic symptoms of fever, weight loss, anorexia, night sweats and other organ dependent symptoms based on the metastatic spread of the lymphoma. Complications arise from the systemic effects of the | Follicular lymphoma presents in the age group of 60-65 with systemic symptoms of [[fever]], [[weight loss]], [[anorexia]], [[night sweats]] and other organ dependent symptoms based on the [[Metastasis|metastatic]] spread of the lymphoma. Complications arise from the systemic effects of the lymphoma and metastasis. The prognosis is evaluated from follicular lymphoma international prognostic index which divides patients into 3 groups. | ||
== Natural history == | == Natural history == | ||
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* Patients may present with complaints of: | * Patients may present with complaints of: | ||
** Unexplained fever | ** Unexplained fever | ||
** Weight loss | ** [[Weight loss]] | ||
** Painless and progressive adenopathy | ** Painless and progressive [[adenopathy]] | ||
** Night sweats | ** Night sweats | ||
** Gastric symptoms | ** Gastric symptoms | ||
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* Organ related symptoms develop depending on the metastatic spread of the lymphoma. | * Organ related symptoms develop depending on the metastatic spread of the lymphoma. | ||
* Patients may have a history of: | * Patients may have a history of: | ||
** Viral disease (HIV, HBV, HCV or EBV) | ** Viral disease ([[Human Immunodeficiency Virus (HIV)|HIV]], [[Hepatitis B virus|HBV]], [[Hepatitis C|HCV]] or [[Epstein Barr virus|EBV]]) | ||
** Autoimmune diseases | ** [[Autoimmune diseases]] | ||
** Immunocompromised state | ** [[Immunodeficiency|Immunocompromised]] state | ||
== Complications == | == Complications == | ||
* Skin reactions | * Skin reactions | ||
* Bone marrow suppresion | * [[Bone marrow]] suppresion | ||
* Second cancers | * Second cancers | ||
* | * Gastric obstruction | ||
* Urethral obstruction | * Urethral obstruction | ||
* Renal failure | * [[Renal insufficiency|Renal failure]] | ||
* Infertility | * [[Infertility]] | ||
* Heart problems (Heart failure, vavular defects, pericarditis) | * Heart problems (Heart failure, vavular defects, pericarditis) | ||
* Lung problems (Pleural effusion, lung mass) | * Lung problems (Pleural effusion, lung mass) | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Overview
Follicular lymphoma presents in the age group of 60-65 with systemic symptoms of fever, weight loss, anorexia, night sweats and other organ dependent symptoms based on the metastatic spread of the lymphoma. Complications arise from the systemic effects of the lymphoma and metastasis. The prognosis is evaluated from follicular lymphoma international prognostic index which divides patients into 3 groups.
Natural history
- Follicular lymphoma presents in older age group people of age 60-65[1][2][3][4].
- Patients may present with complaints of:
- Unexplained fever
- Weight loss
- Painless and progressive adenopathy
- Night sweats
- Gastric symptoms
- Urinary symptoms
- Nerve lesions
- Constant fatigue
- Itchy skin
- Reddened patches on the skin
- Cough
- Shortness of breath
- Organ related symptoms develop depending on the metastatic spread of the lymphoma.
- Patients may have a history of:
- Viral disease (HIV, HBV, HCV or EBV)
- Autoimmune diseases
- Immunocompromised state
Complications
- Skin reactions
- Bone marrow suppresion
- Second cancers
- Gastric obstruction
- Urethral obstruction
- Renal failure
- Infertility
- Heart problems (Heart failure, vavular defects, pericarditis)
- Lung problems (Pleural effusion, lung mass)
- Mediastinal mass
- Immune system deficiency
Prognosis
- Follicular Lymphoma International Prognostic Index (FLIPI) is used for the evaluation of prognosis[5][6].
- It includes the following:
- age >60 years
- bone marrow involvement
- hemoglobin level <12.0 g/dl
- greatest diameter of the largest involved node >6 cm
- elevated serum β-2 microglobulin level
- The FLIPI divides pateints into 3 groups:
- Low (0-1 risk factor)
- Intermediate (2 risk factors)
- High (≥ 3 risk factors)
- The 10 year mortality of low group is 96%.
- The 10 year mortality of intermediate group is 71%.
- The 10 year mortality of high group is 37%.
References
- ↑ Kridel R, Sehn LH, Gascoyne RD (2012). "Pathogenesis of follicular lymphoma". J Clin Invest. 122 (10): 3424–31. doi:10.1172/JCI63186. PMC 3461914. PMID 23023713.
- ↑ "A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin's lymphoma. The Non-Hodgkin's Lymphoma Classification Project". Blood. 89 (11): 3909–18. 1997. PMID 9166827.
- ↑ Winberg CD, Nathwani BN, Bearman RM, Rappaport H (1981). "Follicular (nodular) lymphoma during the first two decades of life: a clinicopathologic study of 12 patients". Cancer. 48 (10): 2223–35. PMID 7028244.
- ↑ Fernández de Larrea C, Martínez-Pozo A, Mercadal S, García A, Gutierrez-García G, Valera A; et al. (2011). "Initial features and outcome of cutaneous and non-cutaneous primary extranodal follicular lymphoma". Br J Haematol. 153 (3): 334–40. doi:10.1111/j.1365-2141.2011.08596.x. PMID 21375524.
- ↑ Solal-Céligny P, Roy P, Colombat P, White J, Armitage JO, Arranz-Saez R; et al. (2004). "Follicular lymphoma international prognostic index". Blood. 104 (5): 1258–65. doi:10.1182/blood-2003-12-4434. PMID 15126323.
- ↑ Martin AR, Weisenburger DD, Chan WC, Ruby EI, Anderson JR, Vose JM; et al. (1995). "Prognostic value of cellular proliferation and histologic grade in follicular lymphoma". Blood. 85 (12): 3671–8. PMID 7780151.