Treatment
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 of a watch and wait approach as early treatment does not provide survival benefit. 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.
Personalised idiotype vaccines have shown great promise, but has still to prove its efficacy in randomized clinical trials.
In 2010 Rituximab was approved by the EC for first-line maintenance treatment of follicular lymphoma.
Trial results released in June 2012 show that bendamustine, a drug first developed in East Germany in the 1960s, more than doubled disease progression-free survival when given along with rituximab. The combination also left patients with fewer side effects than the older treatment (a combination of five drugs -- rituximab, cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), vincristine and prednisone, collectively called R-CHOP).
There are a large number of recent and current clinical trials for FL.
Read more about this topic: Follicular Lymphoma
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