How I Treat Early Progression in Follicular Lymphoma
All patients with follicular lymphoma will experience disease relapse, but not all relapse is the same. Approximately 20% of patients treated with initial chemoimmunotherapy will progress within 24 months of initial treatment; this “POD24” group of patients has a dismal survival of only 50% at 5 years, far inferior to patients not experiencing POD24. How should these patients be treated? Is this just another relapse typical of follicular lymphoma? The preponderance of data suggests that this is a unique disease event, with a very poor prognosis. Despite this understanding, there is no consensus on the best management. We will discuss identification of POD24, treatment options available to the clinician, and trials that hope to change the otherwise poor disease.
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