In patients with follicular lymphoma, you need to know, don't miss it.

Follicular lymphoma (FL) is one of the most common B-cell lymphoma in non Hodgkin's lymphoma except diffuse large B-cell lymphoma. It is also a subtype of lymphoma with high cure rate after drug treatment.in recent years, the incidence rate of FL has increased in China. Experts speculate that it is associated with lifestyle changes and increased viral infections.definition and staging FL is derived from the germinal center B cells (GCB). Morphologically, FL retains the follicular growth pattern. It is a group of malignant lymphoproliferative diseases including follicular center cells (small split cells) and follicular center mother cells (large apheresis cells).FL was mainly characterized by tumor GCB proliferation, including central cells and central mother cells.the current FL classification system takes the ratio of central cells to central mother cells as an evaluation index: ➤ level 1: 0-5 centroblasts can be seen in each high power field of light microscope ➤ Level 2: 6-15 central mother cells can be seen in each high power field of optical microscope ➤ Level 3: visible in each high power field of light microscope & gt; There were 15 Central mother cells, and the central mother cells were distributed in flakes, lacking of central cells.note: Grade 3 FL is further divided into fl3a and fl3b, and the course of fl3b is similar to that of diffuse large B-cell lymphoma.the first-line treatment of follicular lymphoma: the first-line treatment plan was selected. According to the classification and staging, gelf tumor load and treatment indications, the stratified treatment strategy of FL was determined.immunochemotherapy is the most commonly used treatment mode in China, and rituximab combined with chemotherapy has become the preferred standard regimen for newly treated FL at home and abroad.(1) R-CHOP Regimen rituximab 375mg / m2, d0 cyclophosphamide 750mg / m2, D1 doxorubicin 50mg / m2, D1 vincristine 1.4mg/m2, D1 (maximum dose 2mg) prednisone 100mg, D1-5 repeated every 21 days (2) r-cvp regimen rituximab 375 mg / m2, d0 cyclophosphamide 750mg / m2, D1 vincristine 1.4mg/m2, D1 prednisone 40mg / m2, D1-5 repeated every 21 days (3) The patients were divided into two groups according to the protocol of bendamustin + rituximab, rituximab 375mg / m2, d0 bendamustin 90mg / m2, D1-2, repeated every 28 days (4) lenalidomide + rituximab regimen, rituximab 375mg / m2, D1, every 28 days At present, the standard treatment of relapsed and refractory FL patients has not been completely unified. The choice of rescue treatment depends on the efficacy of previous regimen, remission time, patient's age, physical status, pathological type of recurrence and treatment objectives.for relapsed and refractory (R / R) FL, in addition to chemotherapy, we can also choose P13K inhibitors, BCL2 inhibitors, Btk inhibitors, EZH2 inhibitors, as well as bispecific antibodies, antibody drug conjugate (ADC), car-t cells and other tumor immune microenvironment therapy.clinical research of PI3K inhibitors at present, a drug clinical study for recurrent and refractory follicular lymphoma is being carried out in China, and the phase II clinical trial of PI3K δ small molecule inhibitor yy20394 in the treatment of recurrent / refractory follicular lymphoma is in progress.test drug and background yy-20394 is a highly selective inhibitor of PI3K δ (phosphatidylinositol 3-kinase subtype δ). It has carried out phase II clinical trial of follicular lymphoma in China, and has been approved by the food and Drug Administration (FDA) to carry out phase II clinical trials in the United States for the treatment of recurrent and / or refractory follicular lymphoma.the main inclusion criteria were: 1. The age was over 18 years old; 2. Patients with recurrent and / or refractory follicular lymphoma diagnosed by histology or cytology; 3. Progression after receiving second-line or above systemic treatment (previous treatment with rituximab and at least one alkylating agent, including but not limited to bendamustine, cyclophosphamide, ifosfamide, chloramphetamine, and mafia) After successful participation in this study, the relevant examination, study drug, expert follow-up and monitoring are free of charge, and certain subject subsidies are provided.if you meet the above requirements or have the intention to join the study, you are welcome to contact yy-20394 research recruitment group. Thank you for your help in forwarding or introducing patients with relapsed or refractory follicular lymphoma.Tel: 010-64405225 to 889 mobile phone: 18516847873 (wechat can be added to communicate at any time) other lymphoma research, other ongoing lymphoma research can be added wechat consultation 1, relapse and refractory diffuse large B lymphoma, age ≥ 18 years old and ≤ 75 years old, gender unlimited; MyD88 diagnosed by tumor tissue pathology In patients with diffuse large B-cell lymphoma (DLBCL) with positive l265p and CD79b mutations, at least one lesion with any axis more than 1.5cm; patients with relapsed or refractory DLBCL who have previously received more than 1 and less than 4 different chemotherapy and / or targeted drugs, and lack of effective and standard treatment options; some patients have failed to respond to the latest systemic treatment (CR / PR) or occur after remission (2) the age of relapsed and refractory marginal zone lymphoma was ≥ 18 years old and ≤ 75 years old, regardless of gender, There is at least one lesion beyond the spleen, with any axis more than 1.5cm; patients with recurrent or refractory marginal zone lymphoma who have previously received more than 1 and ≤ 4 different chemotherapy and / or targeted drug therapy failure, and lack of effective and standard treatment options; there are medical records of no response to the latest systematic treatment (CR / PR) or disease progression after remission; 3. Relapsed refractory primary or The age of secondary central nervous cell lymphoma is ≥ 18 years old and ≤ 75 years old, regardless of gender; primary CNS lymphoma (PCNSL) confirmed by pathology, or secondary CNS lymphoma (scnsl) diagnosed by histopathology as diffuse large B-cell lymphoma (DLBCL); recurrent or refractory PCNSL or scnsl, for CNS lesions, must receive at least one treatment, the number of systematic treatment ≤ 4; cranial Brain MRI or CT scan showed the solid lesions of disease progression; only patients with meningeal lesions needed CSF cytological examination to confirm that lymphoma cells and / or imaging findings were consistent with CSF examination; 4. Relapsed and refractory Fahrenheit macroglobulinemia was more than 18 years old, regardless of gender; clinically and histologically confirmed Fahrenheit macroglobulinemia met at least one treatment indication and had the lowest serum IgM value& Gt; 2-fold ULN was used as the evaluation index of curative effect; previously received more than 1 standard treatment containing chemotherapy regimen, but the recent treatment did not obtain mild remission (MR) or better remission (i.e. ≥ 2 consecutive treatment cycles of SD or PD), or disease progression occurred after remission in the latest treatment; we made progress together with "read the original text"