Treatment of Relapsed Follicular Lymphoma in Need of Treatment

This protocol applies to patients with follicular lymphoma (FL) who have relapsed and now require re-treatment — where high-grade transformation has been excluded and the disease is not resistant to rituximab.

Clinical Scenario

Relapsed follicular lymphoma, in need of treatment. High-grade transformation has been excluded. The disease is not resistant to rituximab.

Treatment Approach

Immunochemotherapy incorporating rituximab is the cornerstone of re-treatment, with regimen selection guided principally by the duration of the prior remission. Depending on treatment response and individual patient fitness, further consolidation or maintenance strategies may be considered.

The complete regimen options, selection criteria, sequencing, and maintenance algorithm are detailed in the full structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

Offer immunochemotherapy to people with relapsed FL in need of treatment.

For those who have achieved a relatively long remission duration, consider repeat therapy with rituximab in combination with the same chemotherapy as administered previously. For those with a shorter remission duration consider rituximab in combination with an alternative chemotherapy regimen from that administered previously.

Consider up to 2 years of rituximab (or obinutuzumab if this agent was used for induction) maintenance for those people who have relapsed disease who have responded to re-induction therapy, have not received antibody maintenance previously and are not suitable for high-dose therapy.

Consider HDT-ASCR for fitter people with relapsed FL who achieve a second or subsequent remission.

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