Articles

Guidelines of the Belgian Hematological Society for newly diagnosed and relapsed follicular lymphoma 2012

BJH - volume 3, issue 2, june 2012

S. Debussche MD, A. Van Hoof MD, PhD, A. Sonnet MD, PhD, C. Bonnet MD, PhD, A. Janssens MD, PhD, G. Verhoef MD, PhD, D. Dierickx MD, PhD, V. De Wilde MD, PhD, D. Bron MD, PhD, W. Schroyens MD, PhD, E. Van den Neste MD, PhD, F. Offner MD, PhD

Summary

Follicular lymphoma is an indolent lymphoma that has occurred more frequently over the last decades. In this article we present an overview of the diagnosis and initial work-up, prognostic scoring system and choice of therapy. For limited stage disease radiotherapy is the treatment of choice, and may have a curative potential. For advanced stages treatment should be initiated upon certain criteria, and is essentially based on immunochemotherapy, rituximab plus chemotherapy. The choice of chemotherapy depends on age, frailty, and specific toxicities of chemotherapy. Maintenance therapy with rituximab after induction has become standard practice. Since virtually all patients relapse eventually, an overview of the treatment in the relapsed setting is given. The treatment is then again based on immunoche-motherapy but there is also a place for radio-immunotherapy, or immunotherapy alone. For young patients, high dose chemotherapy with autologous stem cell rescue should be considered. A brief overview on novel agents, and agents that are in the pipeline, is given. We conclude with some recommendations for follow-up.

(BELG J HEMATOL 2012;3:41–50)

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