Treatment of follicular non-Hodgkin's lymphoma.
Follicular non-Hodgkin's lymphoma (NHL) represents the most common indolent lymphoma with a median survival of 10 years. A new prognostic index (FLIPI) provides prognostic information at diagnosis and at relapse. Initial treatments combining monoclonal antibody therapy using rituximab with chemotherapy appear to increase the response rate and decrease the risk of relapse with little increase in toxicity. Promising phase III trial results demonstrating improvements in outcome using rituximab have recently been reported. A number of phase II trials have also demonstrated encouraging activity combining radiolabeled antibodies in sequence with chemotherapy. The role of high-dose therapy and autologous transplantation is becoming more defined, with improvements in progression-free survival observed in the upfront and relapsed setting. The application of allogeneic transplantation, once restricted to young otherwise healthy patients has shown encouraging activity in older, relapsed, and refractory patients using nonmyeloablative conditioning regimens. These new treatment options make the management of newly diagnosed patients both exciting and a challenge.
Maloney
David G
DG
Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, North Seattle, WA 98104, USA. dmaloney@fhcrc.org
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002883:Chromosomes, Human, Pair 14 / Q000235:genetics / Q000648:ultrastructure; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics / Q000648:ultrastructure; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D019254:Genes, bcl-2; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use; D007167:Immunotherapy; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012074:Remission Induction; D000069283:Rituximab; D016879:Salvage Therapy; D014178:Translocation, Genetic; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018796:Immunoconjugates; D000069283:Rituximab