How I treat a patient with newly diagnosed follicular lymphoma?

Abstract

Treatment of de novo follicular lymphoma (FL) is difficult due to lack of generally accepted standards for therapy. During the first attempt to the patient with FL is mandatory to determine whether the treatment should be applied to the patient without delay or supposed to be postponed (watch and wait stategy). Such decision - to defer treatment or to watch and wait - must be based on the objective and scientific proven criteria as they are prognostic indices (FLIPI/FLIPI2) and clinical algorithms (GELF/BNLI). Rituximab maintenance is considered to be a standard therapeutic strategy for patients achieving clinical response with first-line therapy. Consolidation of the first remission using radioimmunotherapy (RIT) serves as alternative approach. First remission consolidation with autologous hematopoietic stem cell transplantation (auto-HSCT) is recommended only in well designed clinical trials. In this manuscript a comprehensive approach to the therapy of untreated FL is provided.
Hematologia 2010; 1, 4: 320-329