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The Optimal Management of Follicular Lymphoma: An Evolving Field

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Abstract

Follicular lymphoma consists of a heterogeneous group of diseases that can vary dramatically in clinical course. As with other indolent lymphomas, follicular lymphoma is felt to be highly treatable, but ultimately incurable. The appropriate management of this disease ranges from close observation to chemoimmunotherapy based on presenting symptoms and comorbidities. In this article, we focus on the optimal management of follicular lymphoma, including prognostication, indications for treatment, and current treatment options. While a number of front-line chemoimmunotherapy options exist, R-CHOP (rituximab, cyclophosphamide, vincristine, prednisone) and BR (bendamustine, rituximab) tend to be favored due to efficacy and tolerability. Post-induction options include maintenance rituximab and radioimmunotherapy, but neither has demonstrated an overall survival benefit. In relapsed disease, patients can receive an alternative chemoimmunotherapy regimen or radioimmunotherapy, or participate in a clinical trial. There are a number of new biologic targeted therapies with promising activity in follicular lymphoma that have the potential to change our approach to this disease.

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Acknowledgments

Dr. Ujjani has acted as a consultant for MedImmune and Boehringer Ingelheim. Dr. Cheson has been a consultant for Teva, Celgene, Pharmacyclics, Genentech and Merck. No sources of funding were used to assist in the preparation of this review.

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  1. Division of Hematology-Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington, USA

    Chaitra Ujjani & Bruce D. Cheson

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  1. Chaitra Ujjani
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  2. Bruce D. Cheson
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Correspondence to Chaitra Ujjani.

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Ujjani, C., Cheson, B.D. The Optimal Management of Follicular Lymphoma: An Evolving Field. Drugs 73, 1395–1403 (2013). https://doi.org/10.1007/s40265-013-0092-5

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