Follicular lymphoma medical therapy: Difference between revisions
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{{CMG}} {{AE}} {{AS}} | {{CMG}} {{AE}} {{AS}} | ||
==Overview== | ==Overview== | ||
The optimal therapy for follicular lymphoma depends on the stage at diagnosis, age, and prognostic scores. The predominant therapy for follicular lymphoma is chemotherapy. Adjunctive hematopoietic stem cell transplantation | The optimal therapy for follicular lymphoma depends on the stage at diagnosis, age, and prognostic scores. The predominant therapy for follicular lymphoma is chemotherapy. Adjunctive hematopoietic stem cell transplantation and radioimmunotherapy may be required. | ||
==Medical Therapy== | ==Medical Therapy== | ||
There is no consensus regarding the best treatment protocol. Several considerations should be taken into account including age, stage, and prognostic scores. | There is no consensus regarding the best treatment protocol. Several considerations should be taken into account including age, stage, and prognostic scores. | ||
*Patients with advanced disease who are asymptomatic might benefit from a watch and wait approach as early treatment does not provide survival benefit | *Patients with advanced disease who are asymptomatic might benefit from a watch and wait approach as early treatment does not provide survival benefit<ref>Follicular Lymphoma: Perspective, Treatment Options, and Strategy by T. Andrew Lister, MD, FRCP, http://www.medscape.org/viewarticle/709528_transcript</ref><ref>Watchful Waiting in Low–Tumor Burden Follicular Lymphoma in the Rituximab Era: Results of an F2-Study Database http://jco.ascopubs.org/content/30/31/3848.abstract?sid=40023c4f-fb96-484b-a302-1ade09cc741e</ref>. | ||
* When patients are symptomatic, specific treatment is required, which might include various combinations of | * When patients are symptomatic, specific treatment is required, which might include various combinations of | ||
:* Alkylators | :* Alkylators | ||
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:* Monoclonal antibodies [[rituximab]] | :* Monoclonal antibodies [[rituximab]] | ||
:* [[Radioimmunotherapy]] | :* [[Radioimmunotherapy]] | ||
:* Autologous | :* Autologous and allogeneic [[hematopoietic stem cell transplantation]] | ||
* The disease is regarded as incurable (although allogeneic stem cell transplantation may be curative, the mortality from the procedure is too high to be a first line option. The exception is localized disease, which can be cured by local [[irradiation]]. | * The disease is regarded as incurable (although allogeneic stem cell transplantation may be curative, the mortality from the procedure is too high to be a first line option. The exception is localized disease, which can be cured by local [[irradiation]]. | ||
Revision as of 13:40, 28 August 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Overview
The optimal therapy for follicular lymphoma depends on the stage at diagnosis, age, and prognostic scores. The predominant therapy for follicular lymphoma is chemotherapy. Adjunctive hematopoietic stem cell transplantation and radioimmunotherapy may be required.
Medical Therapy
There is no consensus regarding the best treatment protocol. Several considerations should be taken into account including age, stage, and prognostic scores.
- Patients with advanced disease who are asymptomatic might benefit from a watch and wait approach as early treatment does not provide survival benefit[1][2].
- When patients are symptomatic, specific treatment is required, which might include various combinations of
- Alkylators
- Nucleoside analogues
- Anthracycline-containing regimens (e.g., CHOP)
- Monoclonal antibodies rituximab
- Radioimmunotherapy
- Autologous and allogeneic hematopoietic stem cell transplantation
- The disease is regarded as incurable (although allogeneic stem cell transplantation may be curative, the mortality from the procedure is too high to be a first line option. The exception is localized disease, which can be cured by local irradiation.
References
- ↑ Follicular Lymphoma: Perspective, Treatment Options, and Strategy by T. Andrew Lister, MD, FRCP, http://www.medscape.org/viewarticle/709528_transcript
- ↑ Watchful Waiting in Low–Tumor Burden Follicular Lymphoma in the Rituximab Era: Results of an F2-Study Database http://jco.ascopubs.org/content/30/31/3848.abstract?sid=40023c4f-fb96-484b-a302-1ade09cc741e