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Current Management and Novel Approaches to the Management of Follicular Lymphoma

  • Jonathon B. Cohen
  • Brad S. KahlEmail author
Chapter

Abstract

Fortunately, most patients with advanced-stage follicular lymphoma will enjoy prolonged overall survival and can be managed with nonintensive systemic therapy. However, the determination of the timing of initiation of therapy and which treatment should be used remains challenging in the modern era. While most patients who complete induction therapy will remain in remission for several years and can expect survival to be similar to age-matched controls, up to 20% of patients with follicular lymphoma will experience relapse within 24 months, portending a poor prognosis and inferior survival. In this chapter, we will review the utility of watchful waiting in patients with low tumor burden, current approaches to induction therapy, and the potential use of post-induction treatments including rituximab maintenance. We will discuss current investigations designed to explore novel therapies, improve outcomes, and limit toxicities. We will discuss long-term impacts of treatment, including the development of secondary malignancies, which is critical in this disease that is associated with a prolonged survival.

Keywords

Follicular lymphoma Indolent lymphoma Non-Hodgkin lymphoma Chemotherapy Risk stratification Maintenance therapy Toxicities of treatment Disease surveillance Investigational treatment Targeted therapies 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Hematology and Medical OncologyEmory University – Winship Cancer InstituteAtlantaUSA
  2. 2.Department of Internal Medicine, Division of Medical OncologyWashington University School of Medicine – Siteman Cancer Center, Washington UniversitySt. LouisUSA

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