Linfoma folicular primeira linha feat Dr. Daniel Nogueira | HemoView #15

In the fifteenth episode of HemoView, Vanildo and Marco Aurélio welcome Dr. Daniel Nogueira, a hematologist at Hospital Alemão Oswaldo Cruz and Hospital das Clínicas of FMUSP, with a doctorate in follicular lymphoma, to discuss the main challenges in the diagnosis, stratification, and treatment of follicular lymphoma in clinical practice. Throughout the conversation, clinical reasoning is organized around one of the main questions related to the disease: does every patient with follicular lymphoma need to start treatment immediately? The episode explores how symptoms, tumor burden, clinical behavior, and biological heterogeneity impact decision-making, as well as discussing why diagnosis and therapeutic indication are not synonymous in the management of follicular lymphoma. Fundamental topics in hematological practice are also addressed, such as criteria for high tumor burden, asymptomatic patients, prognostic evaluation, use of FLIPI, the role of PET and bone marrow biopsy, diagnostic investigation, and longitudinal follow-up of the disease. The conversation further delves into relevant biological aspects, including t(14;18) rearrangement, BCL2 expression, tumor heterogeneity, epigenetic alterations, transformation into aggressive forms, and how current classifications have better integrated morphology, biology, and clinical behavior. In addition, the episode discusses first-line therapeutic strategies, indication for observation, anti-CD20, systemic therapy, radiotherapy in selected scenarios, maintenance with monoclonal antibodies, and the main factors involved in individualizing treatment. An essential episode for hematologists, clinicians, oncologists, and professionals who follow patients with lymphoproliferative diseases and need to integrate biology, prognosis, and decision-making in clinical practice. Follow HemoView for in-depth technical discussions in hematology.