[Treatment strategies for follicular lymphoma]

Follicular lymphoma (FL) is the most common indolent lymphoma, benefits from anti-CD20 monoclonal antibody therapy, and has a median overall survival of over 15 years. However, it remains incurable in the majority of patients despite the current standard therapeutic strategy. For advanced-stage cases with a low tumor burden, watchful waiting remains the standard treatment. The optimal timing of rituximab monotherapy is a clinical question. For advanced-stage cases with a high tumor burden, the standard of care includes anti-CD20 monoclonal antibody and chemotherapy, followed by maintenance therapy for 2 years in responding cases. The significance of maintenance therapy after bendamustine administration has not been confirmed. Even within the early relapse group, histological transformation is the most important prognostic factor. For refractory FL, anti-CD19 chimeric antigen receptor T-cell therapy and CD20/CD3-bispecific antibodies have shown promising results. This review presents the current FL treatment strategy and prognostic factors.