title: SEOM clinical guidelines for the treatment of follicular non-Hodgkin's lymphoma.
abstract: Follicular non-Hodgkin's lymphoma (FL) is a nodal B lymphoid malignancy that originates from the germinal center of a lymph node. FL is the second most frequent lymphoma subtype. The course of the disease is usually characterised by a typically indolent clinical course, with a median survival rate of 8-10 years, although most patients relapse after treatment. Diagnosis should always be based on a surgical specimen like an excisional node lymph biopsy. The first-line treatment of FL will depend of extension disease, tumour burden, patient symptoms, performance status and also patient decision. The addition of rituximab to conventional chemotherapy has improved ORR, PFS and OS. As first line in patients that need treatment, a combination of chemotherapy with rituximab induction followed by 2 years of rituximab maintenance is the best option. High-dose chemotherapy with autologous stem-cell transplantation in first line has not shown improvement and is not recommended as first-line therapy. Before any treatment decision in relapsed patients, a repeat biopsy is mandatory to rule out a transformation into large cell aggressive lymphoma. Standard treatment is controversial, depends on the efficacy of prior treatment, duration of the time-to-relapse, patient's age and histological findings at relapse.
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. mprovenciop@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Provencio Pulla
authors.affiliation: Servicio de Oncología Médica, Instituto Oncológico de Guipúzcoa, San Sebastián, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Alfaro Lizaso
authors.affiliation: Servicio de Oncología Médica, Complejo Hospitalario Regional Virgen Macarena, Sevilla, Spain.
authors.forename: L
authors.initials: L
authors.lastname: de la Cruz Merino
authors.affiliation: Servicio de Oncología Médica, Hospital Universitari de Sant Joan de Reus, Reus, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Gumá I Padró
authors.affiliation: Servicio de Oncología Médica, Complejo Hospitalario Regional y Virgen de la Victoria, Málaga, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Quero Blanco
authors.affiliation: Servicio de Oncología Médica, Hospital Universitari i Politècnic la Fe, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Gómez Codina
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario de Canarias (H.U.C), San Cristóbal de La Laguna, Tenerife, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Llanos Muñoz
authors.affiliation: Servicio de Oncología Médica, Hospital General Universitario de Elche y Vega Baja, Elche, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Martinez Banaclocha
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canarias, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Rodriguez Abreu
authors.affiliation: Área de Oncología y Hematología, Hospital Costa del Sol, Marbella, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rueda Domínguez
mesh_terms: D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D019468:Disease Management; D055088:Early Detection of Cancer; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000628:therapy*; D008495:Medical Oncology; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic / Q000592:standards*; D011379:Prognosis; D012955:Societies, Medical
keywords: Follicular non-Hodgkin’s lymphoma; Non-Hodgkin lymphoma therapy; Oncohematology malignancies