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Follicular Lymphoma

Follicular lymphoma is the most common sub-type of indolent (slow-growing) NHL, comprising 20% to 30% of all NHL. Follicular lymphoma typically affects middle-aged or older adult. Like most indolent lymphomas, people diagnosed with follicular lymphoma usually have lymphoma in many parts of the body at the time of diagnosis. A small percentage of people with FL can have their lymphoma transform into a more aggressive form of NHL, usually a DLBC over time.

What are the symptoms?

The most common sign of follicular NHL is painless swelling in the lymph nodes of the neck, armpit or groin. More commonly more than one group of nodes is affected.

How is it treated?

Treatment for follicular lymphoma depends on the stage of the lymphoma.

Early stage :If diagnosed at an early stage ( 1 or 2 ) there may be no treatment given ( Watch and Wait) or radiation or chemotherapy could be started.

Later stage: If diagnosed at a later stage ( 3 or 4) and if there are no symptoms Watch and Wait with very close monitoring is an option.  

Once the need for treatment arises the most common treatments include:

Chemotherapy medicines with the addition of a monoclonal antibody. These can be used alone or in combination with radiotherapy Prolonged treatment with MabThera (called MabThera maintenance therapy) may also be used to treat people with follicular NHL who have received treatment for follicular lymphoma and have achieved remission (complete or partial remission). This prolonged administration with MabThera maintenance therapy (generally administered every three months for a period of two years) has been shown to sustain the response obtained from the initial therapy and may improve survival for people with follicular lymphoma.

Follicular NHL usually responds quite well to chemotherapy. However, there is a risk that it may return in future years. At that time, treatment is given again with the aim of achieving remission again. This pattern may repeat itself over many years or some patients with relapsed FL, high-dose chemotherapy and an autologous stem cell transplant (in which patients receive their own stem cells) or an allogeneic stem cell transplant (in which patients receive stem cells from a donor) may provide a prolonged disease-free interval.

It is critical to remember that today's scientific research is continuously evolving. Treatment options may change as new treatments are discovered and current treatments are improved. Therefore, it is important that patients check with their clinician for any treatment updates that may have recently emerged.

Follow Up

Because FL is generally characterized by multiple disease relapses after responses to a variety of treatments, patients in remission should have regular visits with a clinician who is familiar with their medical history as well as with the treatments they have received. Medical tests (such as blood tests CT and PET scans) may be required at various times during remission to evaluate the need for additional treatments.

Some treatments can cause long-term effects or late effects, which can vary based on duration and frequency of treatments, age, gender, and overall health of each patient at the time of treatment. The doctor will check for these effects during follow-up care.

Lymphoma survivors should receive regular medical exams from a physician who is familiar with their medical history as well as the treatments they have received. Survivors and their caregivers are encouraged to keep copies of all medical records and test results as well as information on the types, amounts and duration of all treatments received.

This documentation will be important for keeping track of any effects resulting from treatment or potential disease recurrences.

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