[Molecular pathogenesis and treatment of follicular lymphoma]

Follicular lymphoma (FL) has a wide spectrum of clinical manifestations, ranging from cases that require little or no treatment to cases that are refractory to any treatment. In recent years, advances in DNA and RNA profiling, as well as analysis of the tumor microenvironment, have progressively increased understanding of the underlying molecular pathogenesis of FL. Early progression of disease following immunochemotherapy includes histologic transformation to a more aggressive phenotype, which is associated with poor survival outcomes. Recent advances beyond conventional immunochemotherapy, including small molecular compounds, bispecific antibodies, and CAR-T cell therapy, have expanded therapeutic options and improved prognosis for FL patients. Research suggests that factors associated with treatment efficacy and prognosis may not be consistent across therapeutic agents. A deeper understanding of the molecular biology of FL should pave the way for optimized, individualized treatment sequences.