Current treatment options in follicular lymphoma: science and bias

Follicular lymphoma is a disease usually characterized by sensitivity to treatment but a pattern of multiple recurrences. Over the last decades, a single optimal therapeutic approach could not be identified and agreed upon. As a result, the selection of the treatment employed for a given patient was both a result of clinical science and bias. The outcomes have been recently improved substantially with the implementation of rituximab, an antiCD20 antibody. Randomized studies have documented repeatedly the clinical benefit conferred by its use, both in combination with chemotherapy, as well as monotherapy applied after remission induction. Although such studies have resulted in important conclusions that help formulate a widely accepted model of treatment sequences for patients with follicular lymphoma, there still remains a considerable area of uncertainty, open for speculation and biased choices. The current review intends to describe the current status of follicular lymphoma treatment, making also an effort to distinguished firm knowledge from reasonable speculation.