Treatment of Relapsed Follicular Lymphoma Requiring Therapy (Rituximab-Sensitive, No High-Grade Transformation)
This protocol covers patients with follicular lymphoma that has relapsed and now requires active treatment,
where high-grade histological transformation has been excluded and the disease remains sensitive to rituximab.
Clinical Scenario
Patients in this setting have relapsed follicular lymphoma that warrants intervention.
The eligibility criteria require the absence of high-grade transformation and confirmed
absence of rituximab resistance. Immunochemotherapy is the recommended offer for
patients with relapsed FL who are in need of treatment.
Treatment Approach (Partial Overview)
Where available, radio-immunotherapy (RIT) is among the approaches considered in this setting.
For patients whose clinical profile makes systemic therapy unsuitable, short-course low-dose
radiotherapy represents an additional option for symptom control. Further agents and sequencing
criteria apply depending on the individual patient context.
Full regimen details, eligibility criteria, and sequencing are contained in the complete protocol.
References
- Offer immunochemotherapy to people with relapsed FL in need of treatment.
- Consider RIT (where available) or idelalisib monotherapy for those in need of treatment.
- Two RIT agents are licensed for treatment of relapsed or refractory FL: Yttrium Y-90 ibritumomab tiuxetan (Zevalin) and iodine I-131 tositumomab (BEXXAR).
- Consider low-dose radiotherapy for those with relapsed disease, for symptom control.
- Short-course, low-dose radiotherapy (e.g. 2 × 2 Gy) should also be considered in the management of relapsed FL in certain clinical settings where systemic therapy is inappropriate.
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