Follicular Lymphoma: Relapsed/Refractory
The term “relapsed” refers to disease that reappears or grows again after a period of The absence of disease. Remission does not necessarily indicate that a person is cured. Patients may have complete or partial remission..
The term “A cancer that is resistant to treatment.” is used to describe when the lymphoma does not respond to treatment or when the response to treatment does not last very long.
Although many patients go into a remission that lasts for years after their initial treatment, the disease can often return.
For patients who A disease that reappears or grows again after a period of remission. or become refractory, second-line therapies (treatment given when initial therapy does not work or stops working) are often successful in providing another remission. Some patients who relapse do not need treatment right away, and an “active surveillance” (also known as “watch and wait” or “watchful waiting”) approach might be used. With this strategy, patients’ overall health and disease are monitored through regular checkup visits and various evaluating procedures, 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.
For those who need treatment, the same therapies used for newly diagnosed patients can often be used in patients with relapsed/refractory FL, but additional treatments are also available.
Treatment for relapsed/refractory FL is based on a patient’s age, overall health, symptoms, and the duration of remission from the last treatment they received. Treatment with drugs to stop the growth of rapidly dividing cancer cells, including lymphoma cells., radiation, and Biologic therapies that act specifically against a particular antigen. may be used to treat relapsed/refractory FL. Common second-line regimens include:
- Bendamustine (Treanda) with or without rituximab (Rituxan) or obinutuzumab (Gazyva)
- Copanlisib (Aliqopa)
- Duvelisib (Copiktra)
- Fludarabine (Fludara) and rituximab (Rituxan)
- Idelalisib (Zydelig)
- R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)
- R-CVP (rituximab, cyclophosphamide, vincristine, and prednisone)
- R-FND (rituximab, fludarabine, mitoxantrone, and dexamethasone)
- Rituximab and Hyaluronidase Human (Rituxan Hycela)
Although uncommon, A therapy that is prepared by attaching a radioactive isotope to a monoclonal antibody. (RIT) using an agent such as yttrium-90 ibritumomab tiuxetan (Zevalin), which is a radioactive particle connected to an a substance made by B-lymphocytes that reacts with antigens on toxins, bacteria and some cancer cells and either kills or marks them for removal. that targets Abnormal cell growth that cannot be controlled by the body's natural defenses. Cancerous cells can grow and eventually form tumors. cells, may also be used alone or in combination with chemotherapy to treat relapsed/refractory FL.
Bendamustine is approved for patients with indolent B-cell NHLs, like FL, whose disease is refractory to rituximab. The use of radiation beams (X-rays) to treat a cancer. can be effective in some patients with relapsed/ refractory FL who have large tumors or disease symptoms. Often very low doses of radiation can be quite beneficial.
For some patients with relapsed/refractory FL, high-dose chemotherapy followed by stem cell transplantation may be an option.
To learn more about relapsed/refractory FL, download the Follicular Lymphoma – Relapsed / Refractory Fact Sheet or visit FocusOnFL.org.
Survey Opportunity for Follicular Lymphoma Patients: Our friends at Lymphoma Canada have developed a survey in order to learn more about follicular lymphoma patients and their experience with their treatment. Please click here to participate.