Initial management strategies for follicular lymphoma

• Type of Material: Article
• Authors: Qiushi Chen, Georgia Institute of Technology; Turgay Ayer, Georgia Institute of Technology; Loretta J Nastoupil, Emory University; Miray Seward, Emory University; Hongzheng Zhang, Emory University; Rajni Sinha, Emory University; Christopher R Flowers, Emory University
• Language: English
• Date: 2012-10
• Publisher: Future Medicine: Open Access Journals
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Future Medicine Ltd
• Final Published Version (URL): http://www.futuremedicine.com/doi/abs/10.2217/ijh.12.7
• Title of Journal or Parent Work: International Journal of Hematologic Oncology
• ISSN: 2045-1393
• Volume: 1
• Issue: 1
• Start Page: 35
• End Page: 45
• Grant/Funding Information: This work was supported by CR Flowers’ American Society of Hematology Amos Medical Faculty Development Award, a Georgia Cancer Coalition Distinguished Scientist Award and Cancer Research Award and R21 CA158686-01A1.
• Research Categories: Health Sciences, Oncology

Abstract

SUMMARY Follicular lymphoma (FL) can vary markedly in its initial presentation, and no single standard approach for its initial management has been adopted. Available options for the initial management of FL include watchful waiting, radiation, single-agent rituximab and combination of rituximab and chemotherapy with strategies segregated for patients who have low and high tumor burden disease based on established criteria. However, marked debate occurs regarding the role of watchful waiting in the modern era for low tumor burden, asymptomatic patients, the optimal timing of rituximab, the selection of chemotherapy regimen to partner with rituximab in high tumor burden patients, and strategies for the management of relapsed disease. We provide an evidence-based discussion on these and other issues regarding the management of FL, and propose a mathematical modeling approach for addressing some of these questions.