The Journal of Practical Medicine >

2025 , Vol. 41 >Issue 10: 1502 - 1508

DOI: https://doi.org/10.3969/j.issn.1006-5725.2025.10.011

Clinical Research

Clinical and genetic characteristics of follicular lymphoma with bulky disease

  • Tianyuan XU ,
  • Ruichi LI ,
  • Rui SUN ,
  • Nan WANG ,
  • Shu CHENG ,
  • Li WANG ,
  • Pengpeng XU ,
  • Weili ZHAO ,
  • Zhong. ZHENG
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  • Shanghai Institute of Hematology，State Key Laboratory of Medica Genomics，National Research Center for Translational Medicine at Shanghai，Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine，Shanghai 200025，Shanghai，China

Received date: 2025-02-27

  Online published: 2025-05-21

Fold

Abstract

Objective To explore the characteristics and prognosis of follicular lymphoma （FL） with bulky disease under rituximab-based first-line treatment. Methods A retrospective analysis was conducted on 525 FL patients diagnosed between September 2009 and September 2021 who received rituximab as a first-line treatment ［342 patients received rituximab combined with chemotherapy （R-chemo）， 183 patients received rituximab plus lenalidomide （R2）］. The clinicopathologic characteristics， gene mutations， and prognosis of bulky FL patients were analyzed. Results Compared to non-bulky FL patients， bulky FL patients had a significantly higher proportion of lymph node ≥ 5 sites， ≥2 extranodal involvement， bone marrow involvement， elevated LDH， and a higher proportion in the high-risk group of FLIPI1 and FLIPI2. Gene sequencing revealed a significantly higher mutation rate of ZNF608 in bulky FL patients compared to non-bulky FL patients. In patients receiving R-chemo as the first-line treatment， there was no significant difference in progression-free survival （PFS） and overall survival （OS） between bulky and non-bulky FL patients. However， in patients treated with R2， the PFS and OS of bulky FL patients was significantly shorter. Conclusions Bulky FL patients compared to non-bulky FL patients have a significantly higher proportion of high-risk baseline characteristics. For bulky FL at diagnosis， chemo-free regimens require further exploration on the basis of R2.

Key words： follicular lymphoma; bulky disease; clinicopathologic characteristic; gene mutation; prognostic analysis

Cite this article

Tianyuan XU , Ruichi LI , Rui SUN , Nan WANG , Shu CHENG , Li WANG , Pengpeng XU , Weili ZHAO , Zhong. ZHENG . Clinical and genetic characteristics of follicular lymphoma with bulky disease[J]. The Journal of Practical Medicine, 2025 , 41(10) : 1502 -1508 . DOI: 10.3969/j.issn.1006-5725.2025.10.011

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