ArticleGenome medicine2025
Clinical characteristics and molecular heterogeneity in Follicular lymphoma with extranodal involvement.
Article in Genome medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- [Characteristics and survival analysis of 60 cases of primary diffuse large B-cell lymphoma of the breast].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2026Article
- Prognostic significance of Ki-67 in grade 3A follicular lymphoma and development of a novel PFS nomogram.Annals of hematology · 2026Article
- Clinical characteristics and molecular heterogeneity in Follicular lymphoma with extranodal involvement.Genome medicine · 2025Article
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17 authors.
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Abstract
backgroundFollicular lymphoma (FL) represents the most common subtype of indolent non-Hodgkin's lymphoma. Extranodal involvement (ENI) indicates a poor clinical outcome in patients who received rituximab-based immunochemotherapy. Recent studies indicate that genetic alterations and tumor microenvironment dysregulation drive extranodal dissemination and lymphoma progression. However, the molecular mechanisms underlying ENI in FL remain to be fully elucidated.
methodsAiming to investigate the influence of oncogenic mutations and tumor microenvironment alterations on ENI in FL, the clinical features of 501 patients with newly diagnosed FL receiving rituximab-based therapy were analyzed, with DNA and RNA sequencing performed on 403 and 175 patients, respectively.
resultsMultiple ENI was observed in 120 (24%) patients and was significantly related to advanced Ann Arbor stage, decreased hemoglobin, elevated lactate dehydrogenase, elevated beta-2 microglobulin, lymph nodes ≥ 5 sites, lymph nodes > 6 cm, and high risk of progression of disease within 2 years (POD24). Increased KMT2D, CREBBP, CARD11, and STAT6 mutations, as well as downregulation of immune-associated pathways and alterations in lipid metabolism, were associated with multiple ENI. In the rituximab plus chemotherapy (R-chemo) cohort (n = 344), involvement of bone marrow, lung, liver, bones, and kidney/adrenal glands were unfavorable predictors of progression-free survival (PFS), with involvement of liver and kidney/adrenal glands as unfavorable predictors of overall survival (OS). However, in the rituximab plus lenalidomide immunotherapy (R2) cohort (n = 157), no ENI site showed a significant difference in PFS and OS.
conclusionsNegative prognostic impact of multiple ENI upon R-chemo therapy could be overcome by R2 therapy in FL. Better understanding of the biological behavior of multiple ENI could provide a potential clinical rationale for future mechanism-based therapy of FL.
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