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When to treat patients with follicular lymphoma

Monday, April 4, 2016

"Patients with follicular lymphoma have really the expectation that they will relapse several times over the years. About 80% with follicular lymphoma won't die of their disease, they'll die with their disease after having lived with it for, in many cases, many years."

- John Leonard, M.D.

In this video, John Leonard, M.D., talks to Targeted Oncology about the inefficacy of early treatment and treatment options for patients with follicular lymphoma. Leonard says the relapse rate for patients with follicular lymphoma is around 80%, though most patients with the malignancy will not pass away from their disease.

Leonard adds that data from recent studies also shows that early treatment of follicular lymphoma does not improve long-term outcomes. After relapse, Leonard says patients should be asking their doctors if they should be doing anything post-relapse and, if so, what the options are. Leonard says one thing doctors should be looking out for is symptomatic progression in patients with follicular lymphoma, at which point treatment should be considered.

In a second video, he discusses the number of options doctors have to choose from when treating follicular lymphomas. Leonard says some of the more common and older options for these patients are the anti-CD20 antibody rituximab and bendamustine, with the latter being used especially if the patient had not previously received it in combination with rituximab.

Leonard says in addition to those treatments, the anti-body obinutuzumab has also been approved in patients with rituximab refractory relapsed follicular lymphoma. Data suggests that idelalisib, a PI3 kinase inhibitor that can work in rituximab refractory patients, and RCHOP chemotherapy are also viable options, according to Leonard. 

In a third video, he discusses treatment considerations for relapsed patients with follicular lymphoma. Several ongoing studies show that early treatment does not necessarily improve long-term outcomes. Factors that influence treatment choices include bulk of disease, symptoms, and asymptomatic progression, Leonard adds.