{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:02:47Z","timestamp":1790744567890,"version":"4.1.0"},"reference-count":43,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,12,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Follicular lymphoma is the most common indolent non-Hodgkin lymphoma in the Western hemisphere. The natural history of FL appears to have been favorably impacted by the introduction of rituximab after randomized clinical trials demonstrated that the addition of rituximab to standard chemotherapy induction has improved the overall survival. Yet, the disease is biologically and clinically heterogeneous with wide variations in outcomes for individual patients. The ability to accurately risk-stratify patients and then tailor therapy to the individual is an area of ongoing research. Historically, tumor grade, tumor burden, and the FL international prognostic index (version 1 and version 2) have been used to distinguish low-risk from high-risk patients. Biologic factors such as mutations in key genes can identify patients at high risk for poor outcomes to first-line therapy (mutational status of 7 genes [EZH2, ARID1A, MEF2B, EP300, FOX01, CREBBP, and CARD11] with Follicular Lymphoma International Prognostic Index). More recently, the quality of the response to initial therapy, as measured by either PET imaging or by remission duration, has been show to identify individuals at high risk. However, several unmet needs remain, including a better ability to identify high-risk patients at diagnosis, the development of predictive biomarkers for targeted agents, and strategies to reduce the risk of transformation.<\/jats:p>","DOI":"10.1182\/asheducation-2017.1.358","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T22:13:11Z","timestamp":1555452791000},"page":"358-364","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":19,"title":["Follicular lymphoma: are we ready for a risk-adapted approach?"],"prefix":"10.1182","volume":"2017","author":[{"given":"Brad S.","family":"Kahl","sequence":"first","affiliation":[{"name":"Division of Oncology, Washington University School of Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"20","key":"2019111703473557600_B1","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1182\/blood-2016-01-643569","article-title":"The 2016 revision of the World Health Organization classification of lymphoid neoplasms","volume":"127","author":"Swerdlow","year":"2016","journal-title":"Blood"},{"issue":"9","key":"2019111703473557600_B2","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.3324\/haematol.2011.042531","article-title":"Follicular lymphoma grade 3B is a distinct neoplasm according to cytogenetic and immunohistochemical profiles","volume":"96","author":"Horn","year":"2011","journal-title":"Haematologica"},{"issue":"2","key":"2019111703473557600_B3","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1365-2141.2011.08942.x","article-title":"Clinical significance of the WHO grades of follicular lymphoma in a population-based cohort of 505 patients with long follow-up times","volume":"156","author":"Wahlin","year":"2012","journal-title":"Br J Haematol"},{"issue":"3","key":"2019111703473557600_B4","doi-asserted-by":"crossref","first-page":"288","DOI":"10.6004\/jnccn.2010.0021","article-title":"NCCN Clinical Practice Guidelines in Oncology: non-Hodgkin\u2019s lymphomas","volume":"8","author":"Zelenetz","year":"2010","journal-title":"J Natl Compr Canc Netw"},{"issue":"3","key":"2019111703473557600_B5","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1200\/JCO.1997.15.3.1110","article-title":"Comparison in low-tumor-burden follicular lymphomas between an initial no-treatment policy, prednimustine, or interferon alfa: a randomized study from the Groupe d\u2019Etude des Lymphomes Folliculaires. 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