Management
Follicular lymphoma, general principles:
- Stage I and II disease is treated with involved field radiation. This is curative in some patients.
- Stage III and IV treatement is palliative, therapy is given over a course of years intermittantly. The indication for
therapy is observable increased extent of disease or threatened organ function especially bone marrow.
- Relapses are treated with either local radiotherapy (if localised disease), peripheral blood stem cell transplant
(early relapse) or with re-treatement as for initial therapy (late relapse).
Mrs Smith had grade 3A follicular lymphoma, Stage 3A disease.
The usual regimen for follicualr lymphoma is Rituximab with CVP chemotherapy.
Grade 3A follicular lymphoma is an exception to the rule, due to its tendency to act like a high grade lymphoma
(e.g. like diffuse large b-cell lymphoma) and Rituximab with CHOP chemotherpay was used.
Due to her bulky pelvic disease Mrs Smith also received low-molecular weight heparin for DVT prevention.
