Management strategy for follicular lymphoma

Abstract

Follicular lymphoma (FL) is incurable with the current standard therapeutic strategy, although the natural history of FL has improved in the last few decades. Treatment strategy for FL is considered by stage and tumor burden. For advanced-stage FL patients with low tumor burden, monitoring remains an appropriate approach. Single agent rituximab is also suggested as a good alternative. The addition of rituximab to chemotherapy has improved overall survival in advanced-stage FL patients with high tumor burden. The optimal chemotherapy to partner with rituximab might be CHOP or bendamustine. Rituximab maintenance after successful induction rituximab-based chemotherapy prolongs PFS. Recently, progression within 24 months of first-line chemotherapy has been established as a predictor of inferior outcome, with a 50% risk of death in 5 years. Addressing this high-risk group is important for optimal future treatment strategies.