Skip to main content
SpringerLink
Log in

Current Therapeutic Strategies and New Treatment Paradigms for Follicular Lymphoma

  • Chapter
  • First Online:
Non-Hodgkin Lymphoma

Part of the book series: Cancer Treatment and Research ((CTAR,volume 165))

Abstract

Follicular lymphoma (FL) is an indolent non-Hodgkin’s lymphoma that remains an incurable disease for most patients. It is responsive to a variety of different treatments, however it follows a pattern of relapsing and remitting disease. Traditional therapeutic options for patients with untreated FL include expectant observation for asymptomatic and low tumor burden and multiagent cytotoxic chemotherapy for symptomatic and/or high tumor burden. Biologics have become an integral part of therapy with agents that target B lymphocytes, including monoclonal anti-CD20 antibodies and radiolabeled anti-CD20 antibodies. Treatment response to cytotoxic and biologic therapy is high initially; however, with subsequent treatments, response rate and remission duration typically decline and cumulative toxicities increase. The identification of novel targeted agents, use of stem cell transplantation, and new treatment combinations provide the opportunity to enhance patient outcomes. In this review, we critically examine standard treatment strategies for patients with newly diagnosed and relapsed or refractory FL and discuss established and emerging novel therapeutic approaches.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chan WC, Armitage JO, Gascoyne R et al (1997) A clinical evaluation of the international lymphoma study group classification of non-Hodgkin’s lymphoma. The non-Hodgkin’s lymphoma classification project. Blood 89(11):3909–3918

    Google Scholar 

  2. Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS (2006) Lymphoma incidence patterns by WHO subtype in the United States, 1992–2001. Blood 107(1):265–276

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Link BK, Maurer MJ, Nowakowski GS et al (2013) Rates and outcomes of follicular lymphoma transformation in the immunochemotherapy era: a report from the University of Iowa/MayoClinic specialized program of research excellence molecular epidemiology resource. J Clin Oncol 31(26):3272–3278

    Article  PubMed Central  PubMed  Google Scholar 

  4. Tan D, Horning SJ, Hoppe RT et al (2013) Improvements in observed and relative survival in follicular grade 1-2 lymphoma during 4 decades: the Stanford University experience. Blood 122(6):981–987

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Nabhan C, Aschebrook-Kilfoy B, Chiu BC, Kruczek K, Smith SM, Evens AM (2014) The impact of race, age, and sex in follicular lymphoma: a comprehensive SEER analysis across consecutive treatment eras. Am J Hematol 89(6):633–638

    Article  PubMed  Google Scholar 

  6. Federico M, Luminari S, Dondi A et al (2013) R-CVP versus R-CHOP versus R-FM for the initial treatment of patients with advanced-stage follicular lymphoma: results of the FOLL05 trial conducted by the Fondazione Italiana Linfomi. J Clin Oncol 31(12):1506–1513

    Article  CAS  PubMed  Google Scholar 

  7. Brice P, Bastion Y, Lepage E et al (1997) Comparison in low-tumor-burden follicular lymphomas between an initial no-treatment policy, prednimustine, or interferon alfa: a randomized study from the Groupe d’Etude des Lymphomes Folliculaires. Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol 15(3):1110–1117

    CAS  PubMed  Google Scholar 

  8. Solal-Celigny P, Lepage E, Brousse N et al (1998) Doxorubicin-containing regimen with or without interferon alfa-2b for advanced follicular lymphomas: final analysis of survival and toxicity in the Groupe d’Etude des Lymphomes Folliculaires 86 Trial. J Clin Oncol 16(7):2332–2338

    CAS  PubMed  Google Scholar 

  9. Ardeshna KM, Qian W, Smith P et al (2014) Rituximab versus a watch-and-wait approach in patients with advanced-stage, asymptomatic, non-bulky follicular lymphoma: an open-label randomised phase 3 trial. Lancet Oncol 15(4):424–435

    Article  CAS  PubMed  Google Scholar 

  10. Ardeshna KM, Smith P, Norton A et al (2003) Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage non-Hodgkin lymphoma: a randomised controlled trial. Lancet 362(9383):516–522

    Article  CAS  PubMed  Google Scholar 

  11. Buske C, Hoster E, Dreyling M, Hasford J, Unterhalt M, Hiddemann W (2006) The follicular lymphoma international prognostic index (FLIPI) separates high-risk from intermediate- or low-risk patients with advanced-stage follicular lymphoma treated front-line with rituximab and the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) with respect to treatment outcome. Blood 108(5):1504–1508

    Article  CAS  PubMed  Google Scholar 

  12. Colombat P, Salles G, Brousse N et al (2001) Rituximab (anti-CD20 monoclonal antibody) as single first-line therapy for patients with follicular lymphoma with a low tumor burden: clinical and molecular evaluation. Blood 97(1):101–106

    Article  CAS  PubMed  Google Scholar 

  13. Hiddemann W, Kneba M, Dreyling M et al (2005) Frontline therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly improves the outcome for patients with advanced-stage follicular lymphoma compared with therapy with CHOP alone: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group. Blood 106(12):3725–3732

    Article  CAS  PubMed  Google Scholar 

  14. Romaguera JE, McLaughlin P, North L et al (1991) Multivariate analysis of prognostic factors in stage IV follicular low-grade lymphoma: a risk model. J Clin Oncol 9(5):762–769

    CAS  PubMed  Google Scholar 

  15. Salles G, Mounier N, de Guibert S et al (2008) Rituximab combined with chemotherapy and interferon in follicular lymphoma patients: results of the GELA-GOELAMS FL2000 study. Blood 112(13):4824–4831

    Article  CAS  PubMed  Google Scholar 

  16. Salles G, Seymour JF, Offner F et al (2011) Rituximab maintenance for 2 years in patients with high tumour burden follicular lymphoma responding to rituximab plus chemotherapy (PRIMA): a phase 3, randomised controlled trial. Lancet 377(9759):42–51

    Article  CAS  PubMed  Google Scholar 

  17. Herold M, Haas A, Srock S et al (2007) Rituximab added to first-line mitoxantrone, chlorambucil, and prednisolone chemotherapy followed by interferon maintenance prolongs survival in patients with advanced follicular lymphoma: an East German Study Group Hematology and Oncology Study. J Clin Oncol 25(15):1986–1992

    Article  CAS  PubMed  Google Scholar 

  18. Kahl BS (2006) Eastern Cooperative Oncology Group 4402: rituximab extended schedule or retreatment trial (RESORT). Clin Lymphoma Myeloma. 6(5):423–426

    Article  CAS  PubMed  Google Scholar 

  19. Solal-Celigny P, Roy P, Colombat P et al (2004) Follicular lymphoma international prognostic index. Blood 104(5):1258–1265

    Article  CAS  PubMed  Google Scholar 

  20. Plancarte F, Lopez-Guillermo A, Arenillas L et al (2006) Follicular lymphoma in early stages: high risk of relapse and usefulness of the follicular lymphoma international prognostic index to predict the outcome of patients. Eur J Haematol 76(1):58–63

    Article  PubMed  Google Scholar 

  21. Montoto S, Lopez-Guillermo A, Altes A et al (2004) Predictive value of follicular lymphoma international prognostic index (FLIPI) in patients with follicular lymphoma at first progression. Ann Oncol 15(10):1484–1489

    Article  CAS  PubMed  Google Scholar 

  22. Friedberg JW, Taylor MD, Cerhan JR et al (2009) Follicular lymphoma in the United States: first report of the national LymphoCare study. J Clin Oncol 27(8):1202–1208

    Article  PubMed Central  PubMed  Google Scholar 

  23. Mac Manus MP, Hoppe RT (1996) Is radiotherapy curative for stage I and II low-grade follicular lymphoma? Results of a long-term follow-up study of patients treated at Stanford University. J Clin Oncol 14(4):1282–1290

    CAS  PubMed  Google Scholar 

  24. Tsang RW, Gospodarowicz MK (2005) Radiation therapy for localized low-grade non-Hodgkin’s lymphomas. Hematol Oncol 23(1):10–17

    Article  PubMed  Google Scholar 

  25. Seymour JF, Pro B, Fuller LM et al (2003) Long-term follow-up of a prospective study of combined modality therapy for stage I-II indolent non-Hodgkin’s lymphoma. J Clin Oncol 21(11):2115–2122

    Article  CAS  PubMed  Google Scholar 

  26. Advani R, Rosenberg SA, Horning SJ (2004) Stage I and II follicular non-Hodgkin’s lymphoma: long-term follow-up of no initial therapy. J Clin Oncol 22(8):1454–1459

    Article  PubMed  Google Scholar 

  27. Solal-Celigny P, Bellei M, Marcheselli L et al (2012) Watchful waiting in low-tumor burden follicular lymphoma in the rituximab era: results of an F2-study database. J Clin Oncol 30(31):3848–3853

    Article  PubMed  Google Scholar 

  28. Li ZM, Ghielmini M, Moccia AA (2013) Managing newly diagnosed follicular lymphoma: state of the art and future perspectives. Expert Rev Anticancer Ther 13(3):313–325

    Article  CAS  PubMed  Google Scholar 

  29. Forstpointner R, Dreyling M, Repp R et al (2004) The addition of rituximab to a combination of fludarabine, cyclophosphamide, mitoxantrone (FCM) significantly increases the response rate and prolongs survival as compared with FCM alone in patients with relapsed and refractory follicular and mantle cell lymphomas: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group. Blood 104(10):3064–3071

    Article  CAS  PubMed  Google Scholar 

  30. Foussard C, Colombat P, Maisonneuve H et al (2005) Long-term follow-up of a randomized trial of fludarabine-mitoxantrone, compared with cyclophosphamide, doxorubicin, vindesine, prednisone (CHVP), as first-line treatment of elderly patients with advanced, low-grade non-Hodgkin’s lymphoma before the era of monoclonal antibodies. Ann Oncol 16(3):466–472

    Article  CAS  PubMed  Google Scholar 

  31. Hochster H, Weller E, Gascoyne RD et al (2009) Maintenance rituximab after cyclophosphamide, vincristine, and prednisone prolongs progression-free survival in advanced indolent lymphoma: results of the randomized phase III ECOG1496 study. J Clin Oncol 27(10):1607–1614

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Marcus R, Imrie K, Belch A et al (2005) CVP chemotherapy plus rituximab compared with CVP as first-line treatment for advanced follicular lymphoma. Blood 105(4):1417–1423

    Article  CAS  PubMed  Google Scholar 

  33. Rummel MJ, Al-Batran SE, Kim SZ et al (2005) Bendamustine plus rituximab is effective and has a favorable toxicity profile in the treatment of mantle cell and low-grade non-Hodgkin’s lymphoma. J Clin Oncol 23(15):3383–3389

    Article  CAS  PubMed  Google Scholar 

  34. Rummel MJ, Niederle N, Maschmeyer G et al (2013) Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase 3 non-inferiority trial. Lancet 381(9873):1203–1210

    Article  CAS  PubMed  Google Scholar 

  35. Flinn IW, van der Jagt R, Kahl BS et al (2014) Randomized trial of bendamustine-rituximab or R-CHOP/R-CVP in first-line treatment of indolent NHL or MCL: the BRIGHT study. Blood 123(19):2944–2952

    Article  CAS  PubMed  Google Scholar 

  36. Baum E, Sather H, Nachman J et al (1979) Relapse rates following cessation of chemotherapy during complete remission of acute lymphocytic leukemia. Med Pediatr Oncol 7(1):25–34

    Article  CAS  PubMed  Google Scholar 

  37. Jacobson CA, Freedman AS (2013) One size does not fit all in follicular lymphoma. J Clin Oncol 31(27):3307–3308

    Article  PubMed  Google Scholar 

  38. Kaminski MS, Tuck M, Estes J et al (2005) 131I-tositumomab therapy as initial treatment for follicular lymphoma. N Engl J Med 352(5):441–449

    Article  CAS  PubMed  Google Scholar 

  39. Oliansky DM, Gordon LI, King J et al (2010) The role of cytotoxic therapy with hematopoietic stem cell transplantation in the treatment of follicular lymphoma: an evidence-based review. Biol Blood Marrow Transplant 16(4):443–468

    Google Scholar 

  40. Schaaf M, Reiser M, Borchmann P, Engert A, Skoetz N (2012) High-dose therapy with autologous stem cell transplantation versus chemotherapy or immuno-chemotherapy for follicular lymphoma in adults. Cochrane Database Syst Rev 1:CD007678

    Google Scholar 

  41. Cheson BD, Leonard JP (2008) Monoclonal antibody therapy for B-cell non-Hodgkin’s lymphoma. N Engl J Med 359(6):613–626

    Article  CAS  PubMed  Google Scholar 

  42. Davis TA, Grillo-Lopez AJ, White CA et al (2000) Rituximab anti-CD20 monoclonal antibody therapy in non-Hodgkin’s lymphoma: safety and efficacy of re-treatment. J Clin Oncol 18(17):3135–3143

    CAS  PubMed  Google Scholar 

  43. Friedberg JW, Cohen P, Chen L et al (2008) Bendamustine in patients with rituximab-refractory indolent and transformed non-Hodgkin’s lymphoma: results from a phase II multicenter, single-agent study. J Clin Oncol 26(2):204–210

    Article  CAS  PubMed  Google Scholar 

  44. Sacchi S, Pozzi S, Marcheselli R et al (2007) Rituximab in combination with fludarabine and cyclophosphamide in the treatment of patients with recurrent follicular lymphoma. Cancer 110(1):121–128

    Article  PubMed  Google Scholar 

  45. Tam CS, Wolf M, Prince HM et al (2006) Fludarabine, cyclophosphamide, and rituximab for the treatment of patients with chronic lymphocytic leukemia or indolent non-Hodgkin lymphoma. Cancer 106(11):2412–2420

    Article  CAS  PubMed  Google Scholar 

  46. Al-Tourah AJ, Gill KK, Chhanabhai M et al (2008) Population-based analysis of incidence and outcome of transformed non-Hodgkin’s lymphoma. J Clin Oncol 26(32):5165–5169

    Article  PubMed  Google Scholar 

  47. Carney DA, Westerman DA, Tam CS et al (2010) Therapy-related myelodysplastic syndrome and acute myeloid leukemia following fludarabine combination chemotherapy. Leukemia 24(12):2056–2062

    Article  CAS  PubMed  Google Scholar 

  48. Waterman J, Rybicki L, Bolwell B et al (2012) Fludarabine as a risk factor for poor stem cell harvest, treatment-related MDS and AML in follicular lymphoma patients after autologous hematopoietic cell transplantation. Bone Marrow Transplant 47(4):488–493

    Article  CAS  PubMed  Google Scholar 

  49. Janikova A, Koristek Z, Vinklarkova J et al (2009) Efficacious but insidious: a retrospective analysis of fludarabine-induced myelotoxicity using long-term culture-initiating cells in 100 follicular lymphoma patients. Exp Hematol 37(11):1266–1273

    Article  CAS  PubMed  Google Scholar 

  50. Lanza F, Lemoli RM, Olivieri A et al (2014) Factors affecting successful mobilization with plerixafor: an Italian prospective survey in 215 patients with multiple myeloma and lymphoma. Transfusion. 54(2):331–339

    CAS  PubMed  Google Scholar 

  51. Wiseman GA, Gordon LI, Multani PS et al (2002) Ibritumomab tiuxetan radioimmunotherapy for patients with relapsed or refractory non-Hodgkin lymphoma and mild thrombocytopenia: a phase II multicenter trial. Blood 99(12):4336–4342

    Article  CAS  PubMed  Google Scholar 

  52. Fisher RI, Kaminski MS, Wahl RL et al (2005) Tositumomab and iodine-131 tositumomab produces durable complete remissions in a subset of heavily pretreated patients with low-grade and transformed non-Hodgkin’s lymphomas. J Clin Oncol 23(30):7565–7573

    Article  CAS  PubMed  Google Scholar 

  53. Derenzini E, Stefoni V, Maglie R et al (2013) Collection of hematopoietic stem cells after previous radioimmunotherapy is feasible and does not impair engraftment after autologous stem cell transplantation in follicular lymphoma. Biol Blood Marrow Transplant 19(12):1695–1701

    Article  CAS  PubMed  Google Scholar 

  54. Czuczman MS, Emmanouilides C, Darif M et al (2007) Treatment-related myelodysplastic syndrome and acute myelogenous leukemia in patients treated with ibritumomab tiuxetan radioimmunotherapy. J Clin Oncol 25(27):4285–4292

    Article  CAS  PubMed  Google Scholar 

  55. Chan EK, Fung S, Gospodarowicz M et al (2011) Palliation by low-dose local radiation therapy for indolent non-Hodgkin lymphoma. Int J Radiat Oncol Biol Phys 81(5):e781–786

    Article  PubMed  Google Scholar 

  56. Montoto S, Corradini P, Dreyling M et al (2013) Indications for hematopoietic stem cell transplantation in patients with follicular lymphoma: a consensus project of the EBMT-lymphoma working party. Haematologica 98(7):1014–1021

    Article  PubMed Central  PubMed  Google Scholar 

  57. Oliansky DM, Gordon LI, King J et al (2010) The role of cytotoxic therapy with hematopoietic stem cell transplantation in the treatment of follicular lymphoma: an evidence-based review. Biol Blood Marrow Transplant 16(4):443–468

    Article  CAS  PubMed  Google Scholar 

  58. Rohatiner AZ, Nadler L, Davies AJ et al (2007) Myeloablative therapy with autologous bone marrow transplantation for follicular lymphoma at the time of second or subsequent remission: long-term follow-up. J Clin Oncol 25(18):2554–2559

    Article  PubMed  Google Scholar 

  59. Evens AM, Vanderplas A, LaCasce AS et al (2013) Stem cell transplantation for follicular lymphoma relapsed/refractory after prior rituximab: a comprehensive analysis from the NCCN lymphoma outcomes project. Cancer 119(20):3662–3671

    CAS  PubMed  Google Scholar 

  60. Khouri IF, McLaughlin P, Saliba RM et al (2008) Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood 111(12):5530–5536

    Article  CAS  PubMed  Google Scholar 

  61. Morschhauser FA, Cartron G, Thieblemont C et al (2013) Obinutuzumab (GA101) monotherapy in relapsed/refractory diffuse large b-cell lymphoma or mantle-cell lymphoma: results from the phase II GAUGUIN study. J Clin Oncol 31(23):2912–2919

    Google Scholar 

  62. Radford J, Davies A, Cartron G, et al (2013) Obinutuzumab (GA101) plus CHOP or FC in relapsed/refractory follicular lymphoma: results of the GAUDI study (BO21000). Blood 122(7):1137–1143

    Google Scholar 

  63. Advani A, Coiffier B, Czuczman MS et al (2010) Safety, pharmacokinetics, and preliminary clinical activity of inotuzumab ozogamicin, a novel immunoconjugate for the treatment of B-cell non-Hodgkin’s lymphoma: results of a phase I study. J Clin Oncol 28(12):2085–2093

    Google Scholar 

  64. Negrea GO, Elstrom R, Allen SL et al (2011) Subcutaneous injections of low-dose veltuzumab (humanized anti-CD20 antibody) are safe and active in patients with indolent non-Hodgkin’s lymphoma. Haematologica 96(4):567–573

    Google Scholar 

  65. Genovese MC, Kaine JL, Lowenstein MB et al (2008) Ocrelizumab, a humanized anti-CD20 monoclonal antibody, in the treatment of patients with rheumatoid arthritis: a phase I/II randomized, blinded, placebo-controlled, dose-ranging study. Arthritis Rheum 58(9):2652–2661

    Article  PubMed  Google Scholar 

  66. Morschhauser F, Marlton P, Vitolo U et al (2010) Results of a phase I/II study of ocrelizumab, a fully humanized anti-CD20 mAb, in patients with relapsed/refractory follicular lymphoma. Ann Oncol 21(9):1870–1876

    Google Scholar 

  67. Casulo C, Vose JM, Ho WY et al (2014) A phase I study of PRO131921, a novel anti-CD20 monoclonal antibody in patients with relapsed/refractory CD20 + indolent NHL: correlation between clinical responses and AUC pharmacokinetics. Clin Immunol 154(1):37–46

    Google Scholar 

  68. Leonard JP, Schuster SJ, Emmanouilides C et al (2008) Durable complete responses from therapy with combined epratuzumab and rituximab: final results from an international multicenter, phase 2 study in recurrent, indolent, non-Hodgkin lymphoma. Cancer 113(10):2714–2723

    Article  CAS  PubMed  Google Scholar 

  69. Younes A, Kim S, Romaguera J et al (2012) Phase I multidose-escalation study of the anti-CD19 maytansinoid immunoconjugate SAR3419 administered by intravenous infusion every 3 weeks to patients with relapsed/refractory B-cell lymphoma. J Clin Oncol 30(22):2776–2782

    Google Scholar 

  70. Fayad L, Offner F, Smith MR et al (2013) Safety and clinical activity of a combination therapy comprising two antibody-based targeting agents for the treatment of non-Hodgkin lymphoma: results of a phase I/II study evaluating the immunoconjugate inotuzumab ozogamicin with rituximab. J Clin Oncol 31(5):573–583

    Google Scholar 

  71. Flinn IW, Kahl BS, Leonard JP et al (2014) Idelalisib, a selective inhibitor of phosphatidylinositol 3-kinase-delta, as therapy for previously treated indolent non-Hodgkin lymphoma. Blood 123(22):3406–3413

    Google Scholar 

  72. Gopal AK, Kahl BS, de Vos S et al (2014) PI3Kdelta inhibition by idelalisib in patients with relapsed indolent lymphoma. N Engl J Med 370(11):1008-1018

    Google Scholar 

  73. Wang M, Fowler N, Wagner-Bartak N et al (2013) Oral lenalidomide with rituximab in relapsed or refractory diffuse large cell, follicular and transformed lymphoma: a phase II clinical trial. Leukemia 27(9):1902–1909

    Google Scholar 

  74. Friedberg JW, Vose JM, Kelly JL et al (2011) The combination of bendamustine, bortezomib, and rituximab for patients with relapsed/refractory indolent and mantle cell non-Hodgkin lymphoma. Blood 117(10):2807–2812

    Google Scholar 

  75. Coiffier B, Li W, Henitz ED et al (2013) Prespecified candidate biomarkers identify follicular lymphoma patients who achieved longer progression-free survival with bortezomib-rituximab versus rituximab. Clin Cancer Res 19(9):2551–2561

    Article  CAS  PubMed  Google Scholar 

  76. Zinzani PL, Khuageva NK, Wang H et al (2012) Bortezomib plus rituximab versus rituximab in patients with high-risk, relapsed, rituximab-naive or rituximab-sensitive follicular lymphoma: subgroup analysis of a randomized phase 3 trial. J Hematol Oncol 5:67

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  77. Ramsay AG, Clear AJ, Kelly G et al (2009) Follicular lymphoma cells induce T-cell immunologic synapse dysfunction that can be repaired with lenalidomide: implications for the tumor microenvironment and immunotherapy. Blood 114(21):4713–4720

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  78. Fowler NH, Davis RE, Rawal S et al (2014) Safety and activity of lenalidomide and rituximab in untreated indolent lymphoma: an open-label, phase 2 trial. Lancet Oncol 15(12):1311–1318

    Google Scholar 

  79. Evens AM, Smith MR, Lossos IS et al (2014) Frontline bortezomib and rituximab for the treatment of newly diagnosed high tumour burden indolent non-Hodgkin lymphoma: a multicentre phase II study. Br J Haematol 166(4):514–520

    Article  CAS  PubMed  Google Scholar 

  80. Witzig TE, Wiernik PH, Moore T et al (2009) Lenalidomide oral monotherapy produces durable responses in relapsed or refractory indolent non-Hodgkin’s lymphoma. J Clin Oncol 27(32):5404–5409

    Article  CAS  PubMed  Google Scholar 

  81. Kirschbaum M, Frankel P, Popplewell L et al (2011) Phase II study of vorinostat for treatment of relapsed or refractory indolent non-Hodgkin’s lymphoma and mantle cell lymphoma. J Clin Oncol 29(9):1198–1203

    Google Scholar 

  82. Smith SM, van Besien K, Karrison T et al (2010) Temsirolimus has activity in non-mantle cell non-Hodgkin’s lymphoma subtypes: the University of Chicago phase II consortium. J Clin Oncol 28(31):4740–4746

    Google Scholar 

  83. Westin JR, Chu F, Zhang M et al (2014) Safety and activity of PD1 blockade by pidilizumab in combination with rituximab in patients with relapsed follicular lymphoma: a single group, open-label, phase 2 trial. Lancet Oncol 15(1):69–77

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  84. van Oers MH, Klasa R, Marcus RE et al (2006) Rituximab maintenance improves clinical outcome of relapsed/resistant follicular non-Hodgkin lymphoma in patients both with and without rituximab during induction: results of a prospective randomized phase 3 intergroup trial. Blood 108(10):3295–3301

    Article  PubMed  Google Scholar 

  85. Horning SJ, Negrin RS, Hoppe RT et al (2001) High-dose therapy and autologous bone marrow transplantation for follicular lymphoma in first complete or partial remission: results of a phase II clinical trial. Blood 97(2):404–409

    Article  CAS  PubMed  Google Scholar 

  86. Lenz G, Dreyling M, Schiegnitz E et al (2004) Myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission prolongs progression-free survival in follicular lymphoma: results of a prospective, randomized trial of the German Low-Grade Lymphoma Study Group. Blood 104(9):2667–2674

    Article  CAS  PubMed  Google Scholar 

  87. Lenz G, Dreyling M, Schiegnitz E et al (2004) Moderate increase of secondary hematologic malignancies after myeloablative radiochemotherapy and autologous stem-cell transplantation in patients with indolent lymphoma: results of a prospective randomized trial of the German Low Grade Lymphoma Study Group. J Clin Oncol 22(24):4926–4933

    Article  PubMed  Google Scholar 

  88. Sebban C, Mounier N, Brousse N et al (2006) Standard chemotherapy with interferon compared with CHOP followed by high-dose therapy with autologous stem cell transplantation in untreated patients with advanced follicular lymphoma: the GELF-94 randomized study from the Groupe d’Etude des Lymphomes de l’Adulte (GELA). Blood 108(8):2540–2544

    Article  CAS  PubMed  Google Scholar 

  89. Ladetto M, De Marco F, Benedetti F et al (2008) Prospective, multicenter randomized GITMO/IIL trial comparing intensive (R-HDS) versus conventional (CHOP-R) chemoimmunotherapy in high-risk follicular lymphoma at diagnosis: the superior disease control of R-HDS does not translate into an overall survival advantage. Blood 111(8):4004–4013

    Article  CAS  PubMed  Google Scholar 

  90. Gyan E, Foussard C, Bertrand P et al (2009) High-dose therapy followed by autologous purged stem cell transplantation and doxorubicin-based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS with final results after a median follow-up of 9 years. Blood 113(5):995–1001

    Article  CAS  PubMed  Google Scholar 

  91. Federico M et al (2009) Follicular lymphoma international prognostic index 2: a new prognostic index for follicular lymphoma developed by the international follicular lymphoma prognostic factor project. J Clin Oncol 27:1–9

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA

    Athena Kritharis, Jaya Sharma & Andrew M. Evens

Authors
  1. Athena Kritharis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jaya Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew M. Evens
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew M. Evens .

Editor information

Editors and Affiliations

  1. Division of Hematology/Oncology, Tufts Medical Center, Boston, Massachusetts, USA

    Andrew M. Evens

  2. Division of Hematology, Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA

    Kristie A. Blum

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Kritharis, A., Sharma, J., Evens, A.M. (2015). Current Therapeutic Strategies and New Treatment Paradigms for Follicular Lymphoma. In: Evens, A., Blum, K. (eds) Non-Hodgkin Lymphoma. Cancer Treatment and Research, vol 165. Springer, Cham. https://doi.org/10.1007/978-3-319-13150-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-13150-4_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13149-8

  • Online ISBN: 978-3-319-13150-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation