Follicular lymphoma: expanding therapeutic options.
The most common indolent lymphoma, follicular lymphoma comprises 35% of adult non-Hodgkin's lymphoma (NHL) in the United States and 22% worldwide. Features associated with adverse outcome include age, male gender, disease stage, and performance status, with the International Prognostic Index being the most widely used risk classification system. Long-term disease-free survival is possible in select patient subgroups after treatment, but very late relapses suggest that quiescent lymphoma cells might be harbored for long periods of time. Radiation therapy is the mainstay of treatment for limited-stage follicular lymphoma, but there is some experience with chemotherapy and combined chemoradiation. When to initiate treatment in patients with advanced disease is controversial, but options include various combined chemotherapy regimens, monoclonal antibodies, radiolabeled antibodies, and bone marrow or stem cell transplantation. Future directions in the treatment of follicular lymphoma include vaccines, antisense therapy, and proteasome inhibitors.
Ganti
Apar Kishor
AK
Department of Internal Medicine, University of Nebraska, Omaha, Nebraska, USA. aganti@unmc.edu
Bociek
R Gregory
RG
Bierman
Philip J
PJ
Enke
Charles A
CA
Vose
Julie M
JM
Armitage
James O
JO
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D019496:Cancer Vaccines; D003131:Combined Modality Therapy; D006801:Humans; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D016376:Oligonucleotides, Antisense / Q000627:therapeutic use; D036102:Peripheral Blood Stem Cell Transplantation; D061988:Proteasome Inhibitors
D000911:Antibodies, Monoclonal; D019496:Cancer Vaccines; D016376:Oligonucleotides, Antisense; D061988:Proteasome Inhibitors