Transformation in follicular lymphoma: Biology, prognosis, and therapeutic options

Abstract

The transformation of follicular lymphoma to an aggressive lymphoma is a well-recognised complication that occurs at a rate of approximately 3%a year for the first 10 years of observation. Transformation is accompanied by increased risk of refractoriness and a poor expectation of survival. Genetic and epigenetic triggers for transformation have been described. Prior to routine use of rituximab, transformed lymphoma was managed in a fashion similar to that for de novo diffuse large B-cell lymphoma, with generally poor results. Rituximab appears to have improved outcomes. Some centres, including our own, use high-dose chemotherapy with stem cell transplantation as consolidation for those with ..