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Curability Potential of Low-Grade Follicular Lymphoma
F Cabanillas1, J G Conde2, T Gutierrez3
1Centro de Cancer Auxilio Mutuo, San Juan, Puerto Rico; Section of Hematology and Medical Oncology, Department of Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
Clinical Lymphoma, Myeloma & Leukemia
|October 12, 2025
Summary
Early chemotherapy may offer a cure for follicular lymphoma patients, challenging the traditional "watch and wait" approach. Long-term follow-up shows high relapse-free rates, suggesting potential curability with prompt treatment.
Area of Science:
- Oncology
- Hematology
- Clinical Research
Background:
- Classic follicular lymphoma (FL) is often considered incurable.
- Current management involves
- watch and wait
- for low tumor burden or chemotherapy for high tumor burden.
Purpose of the Study:
- To assess the curability of follicular lymphoma using systemic therapy without observation.
- To evaluate the efficacy of early treatment initiation in a real-world cohort.
Main Methods:
- Retrospective analysis of 183 previously untreated low-grade follicular lymphoma (LGFL) patients.
- Treatment stratified by
- clinically discordant indolent histology
- (CDIH) using R-CHOP/FND regimens and rituximab maintenance.
- Primary endpoint: failure-free survival (FFS).
Main Results:
- At 10 years, failure-free survival (FFS) was 80%; at 15 years, 75%.
- Among 61 patients followed over 10 years, 93% remained relapse-free.
- Suggests potential for cure in patients remaining failure-free beyond a decade.
Conclusions:
- Early chemotherapy initiation may lead to cure in classic follicular non-Hodgkin lymphoma (NHL).
- Findings support a paradigm shift from observation to early intervention.
- Further prospective studies are needed for confirmation.
