What are the areas of controversy regarding the treatment of follicular lymphoma (FL)?

Updated: Jan 16, 2019
  • Author: Francisco J Hernandez-Ilizaliturri, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Answer

Answer

The oncologist managing patients with FL faces several challenges, as controversies do exist regarding the following:

  • The best time to start therapy
  • How to navigate treatment options
  • Balancing the efficacy and toxicities in the treatment-decision algorithm
  • The end point to which the success of the individual treatment should be measured

Some clinical scenarios with more straightforward decisions do exist (eg, patients with stage I or II; FL grade 1 or 2 patients with advanced disease [stages III and IV]). Nevertheless, definitions of the best time to initiate therapy continue to divide physicians.

The Groupe d’Etude des Lymphomes Folliculaires (GELF) and the British National Lymphoma Investigation (BNLI) proposed and used defined criteria for patients in whom immediate therapy is necessary. [1, 2]


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