Follicular lymphoma

Abstract

Follicular lymphoma (FL) represents the most common indolent lymphoma in the Western world, accounting for approximately 20% of all NHL and up to 70% of indolent lymphoma. Even though the outcome of patients with FL has improved considerably over the past 30 years, it continues to be considered an incurable disease when it presents with an advanced stage. The variability of presentation at the time of diagnosis results in differences strategies for the initial management. For patients with limited-stage FL, radiation therapy alone is usually the preferred modality. Asymptomatic patients with advanced-stage FL with low tumor burden do not necessarily need an active treatment at the time of diagnosis. The current standard approach for patients with advanced-stage FL with high tumor burden consists of immuno-chemotherapy with an anti-CD20 monoclonal antibody in combination with chemotherapy. Agents that target signal transduction pathways or the non-neoplastic microenvironment alone or combination with rituximab or other monoclonal antibodies have shown promising results in first-line and the relapsed setting. There are high expectations that these agents will be part of the treatment armamentarium against FL. This chapter presents an overview of the current therapeutic options for the management of newly diagnosed and relapsed FL.