Fast Five Quiz: Progression of Follicular Lymphoma

Emmanuel C. Besa, MD


November 10, 2021

Targeted agents appear to provide similar efficacy in patients with FL who have early progression after chemoimmunotherapy as in patients with relapsed disease.

The vast improvement in survival in FL in the past two decades can primarily be attributed to the implementation of anti-CD20 antibody–based therapy (primarily rituximab). Relapsed FL responds relatively well to the immunomodulatory agent lenalidomide, with recent studies showing that the combination of lenalidomide and rituximab is viable as both frontline treatment and therapy for relapsed disease.

Patients with advanced FL do not require immediate treatment unless they have symptomatic nodal or extranodal disease, compromised end-organ function, B symptoms, or cytopenia. There is no overall survival advantage associated with early treatment, either with chemotherapy or single-agent rituximab. Instead, observation is appropriate for asymptomatic patients with low-bulk disease and no cytopenia.

Learn more about management of FL.

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