Guideline on the investigation and management of follicular lymphoma

Dr Kim Linton presents a podcast on the BSH Guideline on the investigation and management of follicular lymphoma.

Follicular lymphoma (FL) is a heterogeneous disease. For many it is experienced as a chronic, relapsing, indolent condition with long overall survival (OS). Most people affected have advanced disease at presentation; symptoms may include B symptoms (i.e. fever, night sweats and weight loss), fatigue and the local mass effect of lymph node enlargement. However, many people are asymptomatic at presentation. Some people are observed without treatment according to a ‘watch and wait’ policy (see section Management of patients with newly diagnosed FL). In contrast to this, over a period of many years, 20–30% of patients will die from refractory FL or following transformation of their disease to high‐grade lymphoma.¹ Prognostic indices may help discriminate between risk groups (see section Prognostic factors in FL).

Dr Linton discusses the guidelines four main focus areas:

1) Important changes on the use of PET scanning.

2) Advances in the upfront management of patients with asymptomatic and symptomatic advance stage disease. 

3) High risk disease in high grade transformation.

4) Advances in the management of relapse with some horizon scanning of promising drugs in development

Dr Kim Linton is Consultant Medical Oncologist at Christie NHS Foundation Trust and Clinical Senior Lecturer at the University of Manchester.