Follicular lymphoma (FL) is one of the most common type of indolent non- Hodgkin’s lymphoma. It originates from germinal center B cells and has characteristic translocation t(11,14) involving immunoglobulin heavy chain gene (chromosome 14q32) and Bcl2 gene (chromosome 18q21) in 90% of patients. FL presents with lymphadenopathy and/or bone marrow involvement. Diagnosis is confirmed by histological examination of lymph nodes. FL is a slow growing tumor with frequent remission and relapses. Follicular lymphoma international prognostic index (FLIPI) and progression of disease within 24 months (POD24) are most important prognostic markers. Early-stage disease is usually treated with radiotherapy. Management of advanced stage depends on disease burden. Patients with advanced stage disease may be observed in case of low burden disease and those with high disease load require treatment with chemo-immunotherapy.
Part of the book: Lymphoma
With an increase in the incidence of acute myeloid leukemia with age, there is a worsening in organ function and the patient’s ability to tolerate intensive therapies. To deliver the best possible care to this vulnerable group and maintain a good quality of life in patients, physicians need to individualize management to minimize adverse effects while still not compromising the prospects of the cure for fit individuals. In this chapter, we will discuss the tools for assessment in older adults and patients and disease-related parameters to be considered for appropriate classification into the fit, unfit, or frail categories. We will also discuss the treatment as per global fitness status, including novel agents, that have recently become available for older acute myeloid leukemia patients.
Part of the book: Leukemia