Non-Hodgkin's lymphomas (nHL) are a heterogenous group of lymphoid malignancies with a different pattern of behaviour and response to treatment. In Europe and North America mainly B-cell lymphomas (86%) are observed. Indolent lymphomas are lymphoproliferative diseases with a relatively good prognosis and long natural history. They usually affect elderly people and more than 90% of cases are diagnosed in advanced stages of the disease. Forty percent all cases of nHL are indolent lymphomas. Indolent lymphomas are curable only in their early stages when radiotherapy is the treatment of choice. In advanced stages chemotherapy is used. However, up till now aggressive chemotherapy does not improve the overall survival rate and it leads to serious adverse events. This article presents current options of management of indolent nHL, especially using purine analogues and monoclonal antibodies.

Purine analogues (fludarabine, 2-chloro-2′desoxyadenosine-2CdA) are thought to be very promising agents as they induce apoptosis and have cytotoxic activity against noncycling lymphocytes which dominate in indolent lymphomas histology. In recent years monoclonal antibodies against antigens present on the lymphoma cells such as rituximab (Mabthera) antiCD20 or alemtuzumab (MabCampath) antiCD52 have been widely used.