Treatment of localized‐stage follicular lymphoma

Abstract

Follicular lymphoma (FL) is the most common indolent lymphoma, and it most frequently presents in an advanced stage. Therapeutic considerations for advanced stage are different from those of localized-stage FL, in which radiotherapy (RT) is generally recommended. However, the available evidence suffers from shortcomings that are relatively specific to this clinical entity due to its rarity and long survival with all available treatment modalities, including that most of the existing evidence originated at a time when diagnostic classifications, staging procedures and radiotherapeutic standards were different from those available today and when anti-CD20 monoclonal antibodies were not available. Available treatment modalities include observation, systemic therapy only, RT only and RT in combination with systemic therapy. We review the evidence available with each of them and the data from present-day clinical practice studies as well as briefly discuss what diagnostic and therapeutic developments may take place in the next few years.

Occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma

“…The patient received no initial therapy for FL. FL is the most common indolent B-cell non-Hodgkin's lymphoma, most of which are diagnosed in an advanced stage (Ann Arbor stage III/IV) [14,16]. Limited stage (Ann Arbor I/II) FL is relatively uncommon; therefore, high-quality evidence for the treatment of limited stage FL is lacking [16].…”

“…FL is the most common indolent B-cell non-Hodgkin's lymphoma, most of which are diagnosed in an advanced stage (Ann Arbor stage III/IV) [14,16]. Limited stage (Ann Arbor I/II) FL is relatively uncommon; therefore, high-quality evidence for the treatment of limited stage FL is lacking [16]. Previous reports in the United States showed that the initial therapy given for stage I patients was as follows: rituximab plus chemotherapy, 28%; radiation therapy, 27%; observation, 17%; systemic therapy plus radiation therapy, 13%; rituximab monotherapy, 12%; and other, 3% [17].…”