Follicular Lymphoma: Treatment Options

There are various treatment options for FL based on the severity of associated symptoms and the rate of cancer growth. If patients show no or very few symptoms, physicians may recommend not to treat the disease right away, an approach referred to as active surveillance (“watch and wait”). Studies have shown that patients who are managed with an active surveillance approach have survival outcomes similar to those who are treated early in the course of their disease. With this strategy, patients’ overall health and disease are monitored through regular checkup visits and various evaluations, such as laboratory and imaging tests. Active treatment is started if the patient begins to develop lymphoma-related symptoms or there are signs that the disease is progressing based on testing during follow-up visits.

FL is generally very responsive to radiation and chemotherapy. Radiation alone can provide a long-lasting remission in some patients with limited disease. In more advanced stages, physicians may use one or more chemotherapy drugs or the monoclonal antibody rituximab (Rituxan), alone or in combination with other agents.

Monoclonal antibodies can act more directly than chemotherapy agents by targeting particular markers found on B-cells and recruiting immune cells to promote tumor destruction, which can increase response to treatment. Common combination regimens include:

  • R-Bendamustine (rituximab and bendamustine)
  • R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)
  • R-CVP (rituximab, cyclophosphamide, vincristine, and prednisone)

Some monoclonal antibodies can also be used as maintenance therapy for up to two years to prolong remission for patients with no signs of lymphoma. Another treatment sometimes used for FL is radioimmunotherapy (RIT) using an agent such as yttrium-90 ibritumomab tiuxetan (Zevalin), which is a radioactive particle connected to an antibody that targets cancer cells.

To learn about treatments under investigation for FL, download the Follicular Lymphoma Fact Sheet or visit FocusOnFL.org.

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