Patients with early stage follicular lymphoma frequently have prolonged overall survival and 40% may remain progression-free 20 years after receiving radiation therapy alone. Thus, such an approach is often considered in this population. Patients with advanced-stage disease but low tumor burden do not achieve a survival benefit by initiation treatment but early therapy with rituximab can improve quality of life and prolong time until need for further treatment and/or chemotherapy. Patients with advanced-stage follicular lymphoma who have low tumor burden should be managed in a personalized fashion taking into account individual feeling regarding treatment, toxicity, and long-term goals.
Keywords: Early stage; Follicular lymphoma; Low tumor burden; Non-Hodgkin lymphoma; Rituximab; Watchful waiting.
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