Clinical, pathological and genetic features of follicular lymphoma grade 3A: a joint analysis of the German low-grade and high-grade lymphoma study groups GLSG and DSHNHL (2023)

FAQs

What is a Grade 3A follicular lymphoma? ›

The grade is based on the number of large, follicular lymphoma cells (centroblasts) that they can see. Grade 1, 2 and 3A are generally thought to be low grade or slow growing. Grade 3B follicular lymphoma is faster growing and is likely to be treated as a high grade lymphoma.

In stages III and IV, you'll have chemotherapy to shrink or slow your cancer. A drug combination called CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or bendamustine can treat more aggressive cancer. Often, rituximab will be added as well.

Half of the patients diagnosed with this type of cancer can live for approximately 10 to 12 years. With radiation therapy, patients with stage I follicular lymphoma are likely to get cured. For patients with stage II, III or IV follicular lymphoma, the average survival rate is higher than 20 years.

Follicular Lymphoma Symptoms

Common symptoms of FL include enlargement of the lymph nodes in the neck, underarms, abdomen, or groin, as well as fatigue, shortness of breath, night sweats, and weight loss.

Follicular non-Hodgkin lymphoma grades 3A and 3B have a similar outcome and appear incurable with anthracycline-based therapy.

Stage 3. This means that you have lymphoma on both sides of the diaphragm. One example is that the lymphoma is in lymph nodes on both sides of the diaphragm. Another example (see below) is that the lymphoma is in lymph nodes above the diaphragm, as well as lymphoma in the spleen.

In stage IIIA, the tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta, or where the trachea divides into the bronchi.

Although exhibiting high response rates and prolonged survival, follicular lymphoma (FL) is still considered an incurable disease. Therefore, the conventional approach currently relies on delaying therapy until necessary, avoiding side effects and long-term toxicities.

As many as 30-40% of individuals may experience aggressive transformation of indolent follicular lymphoma. DLBCL can progress rapidly and spread to areas and organs outside of the lymphatic system (extranodal) and the bone marrow. 'B' symptoms are more common in transformed follicular lymphoma.

Stage III-IV lymphomas are common, still very treatable, and often curable, depending on the NHL subtype. Stage III and stage IV are now considered a single category because they have the same treatment and prognosis.

Can I live a long life with follicular lymphoma? ›

Follicular lymphomas are not usually able to be cured, but may be considered a chronic disease, and patients can live for many years with this form of lymphoma.

For stage I NHL, the 5-year relative survival rate is more than 86%. For stage II the 5-year relative survival rate is 78%, and for stage III it is more than 72%. For stage IV NHL, the 5-year relative survival rate is almost 64%.

In summary, lymphoid follicles are specialized regions of secondary lymphoid organs in which B cells percolate through a lattice of follicular dendritic cells that have captured opsonized antigen on their surfaces. B cells that encounter their cognate antigen and receive T cell help are rescued from death.

Transformation: Follicular lymphoma can change or transform into diffuse large B-cell lymphoma (DLBCL). This is a more aggressive cancer that typically causes new and more significant symptoms, including spreading cancer into other areas of your body. About 3 % of people who have follicular lymphoma develop DLBCL.

Mycosis fungoides is a very slow growing (low grade) type of skin lymphoma. Generally, for people with mycosis fungoides: almost 90 in 100 people (almost 90%) survive 5 years or more after diagnosis.

FL gets its name from the follicles, or clumps of B cells, that form inside your lymph nodes. The cancer's grade provides information about how your B cells appear when examined under a microscope. The stage explains where in your body the lymphoma is located and how far it has spread.

The WHO (2017) has a grading system (Grade 1, 2 or 3) for FL that depends on the percentage of centroblasts, and is as follows: grade 1 (follicular small cleaved): 0 – 5 centroblasts/HPF, grade 2 (follicular mixed): 6 – 15 centroblasts/HPF, grade 3 (follicular large cell): > 15 centroblasts/HPF (grade 3A - centrocytes ...

Transformation: Follicular lymphoma can change or transform into diffuse large B-cell lymphoma (DLBCL). This is a more aggressive cancer that typically causes new and more significant symptoms, including spreading cancer into other areas of your body. About 3 % of people who have follicular lymphoma develop DLBCL.