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Nature and importance of follicular lymphoma precursors

It is now widely recognized that cancer development is a protracted process requiring the stepwise acquisition of multiple oncogenic events. In humans, this process can take decades, if not a lifetime, blurring the notion of 'healthy' individuals. Follicular lymphoma exemplifies this multi...

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Published in:Haematologica (Roma) 2014-05, Vol.99 (5), p.802-810
Main Authors: Mamessier, Emilie, Broussais-Guillaumot, Florence, Chetaille, Bruno, Bouabdallah, Reda, Xerri, Luc, Jaffe, Elaine S, Nadel, Bertrand
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container_issue 5
container_start_page 802
container_title Haematologica (Roma)
container_volume 99
creator Mamessier, Emilie
Broussais-Guillaumot, Florence
Chetaille, Bruno
Bouabdallah, Reda
Xerri, Luc
Jaffe, Elaine S
Nadel, Bertrand
description It is now widely recognized that cancer development is a protracted process requiring the stepwise acquisition of multiple oncogenic events. In humans, this process can take decades, if not a lifetime, blurring the notion of 'healthy' individuals. Follicular lymphoma exemplifies this multistep pathway of oncogenesis. In recent years, variants of follicular lymphoma have been recognized that appear to represent clonal B-cell expansions at an early stage of follicular lymphoma lymphomagenesis. These include follicular lymphoma in situ, duodenal follicular lymphoma, partial involvement by follicular lymphoma, and in the blood circulating follicular lymphoma-like B cells. Recent genetic studies have identified similarities and differences between the early lesions and overt follicular lymphoma, providing important information for understanding their biological evolution. The data indicate that there is already genomic instability at these early stages, even in instances with a low risk for clinical progression. The overexpression of BCL2 in t(14;18)-positive B cells puts them at risk for subsequent genetic aberrations when they re-enter the germinal center and are exposed to the influences of activation-induced cytidine deaminase and somatic hypermutations. The emerging data provide a rationale for clinical management and, in the future, may identify genetic risk factors that warrant early therapeutic intervention.
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subjects Cancer
Cell Transformation, Neoplastic
Humans
Immunology
Immunotherapy
Life Sciences
Lymphoma, Follicular - diagnosis
Lymphoma, Follicular - etiology
Lymphoma, Follicular - pathology
Lymphoma, Follicular - therapy
Precancerous Conditions
Review
title Nature and importance of follicular lymphoma precursors
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