The Management of Follicular Lymphoma

Four treatment modalities for follicular lymphoma are critically appraised, with myelo-ablative therapy with autologous bone marrow transplantation showing encouraging preliminary results, and the use of radiolabelled monoclonal antibodies and purine analogues proving to be useful when other treatments have failed.

Abstract

Follicular lymphoma is demonstrably incurable with conventional treatment. A number of strategies have prolonged the duration of remission. However, none have convincingly improved survival. The following new treatment modalities are currently being evaluated: Interferon, given either alone, in combination with conventional chemotherapy or as maintenance therapy certainly has activity in follicular lymphoma, although its precise role remains to be defined. Myelo-ablative therapy with autologous bone marrow transplantation, with or without in vitro treatment of the marrow, is showing encouraging preliminary results, although longer follow-up is required. The use of radiolabelled monoclonal antibodies is an exciting area of research, with responses being observed in patients in whom other treatments have failed. The purine analogues, for example fludarabine, are an interesting class of new compound. Once more, these are proving to be useful when other treatments have failed. These four treatment modalities are critically appraised in the present paper.