A new guideline on follicular lymphoma (FL) has been published as part of the oncology guideline program. The guideline was developed by 64 experts from 21 specialist societies and organizations under the supervision of the German Society for Hematology and Medical Oncology (DGHO).
The FL is clinically very heterogeneous. According to the Robert Koch Institute, 3,100 patients develop follicular lymphoma in Germany every year. Women are affected more often than men; the average age of disease debut is 66 years.
The new guideline is intended to optimize care and ensure a quality-assured therapy concept in the case of initial illness and relapse. The new guideline provides recommendations for radiation therapy in combination with system therapy for the early stage of the disease. With limited radiation therapy, relapses can occur outside of the radiation area. For this reason, additional treatment with immunotherapy in the form of accompanying antibody treatment may be appropriate.
In an advanced stage of the disease, treatment aims to alleviate disease-related symptoms and to prolong progression-free survival and overall survival. The choice of therapy strongly depends on the symptoms, the clinical course, and the tumor burden. In symptom-free patients in advanced stages, a watch-and-wait approach should be followed, that is, wait-and-see observation.
However, according to the guideline, patients with high tumor burden who suffer from symptoms should be treated with a combination of chemotherapy and antibody therapy, provided that they have no treatment restrictions.
The guideline in German can be found here.
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