The five-year survival rate for follicular lymphoma is between 80 and 90 percent, which means at least 80 to 90 percent of patients diagnosed with follicular lymphoma can live for at least five years after the diagnosis. Half of the patients diagnosed with this type of cancer can live for approximately 10 to 12 years.
With radiation therapy, patients with stage I follicular lymphoma are likely to get cured. For patients with stage II, III or IV follicular lymphoma, the average survival rate is higher than 20 years.
The presence of one or more of the following factors affects the prognosis of a patient with follicular lymphoma:
- Age greater than 60 years
- Stage III or IV at the time of diagnosis
- Involvement of more than four lymph node areas
- Blood tests showing
- A low red blood cell (RBC) count or hemoglobin less than 12 mg/dL
- Elevated levels of lactate dehydrogenase (LDH)
Patients are assigned a point for each poor prognostic factor. Those without any factors will have a score of 0, whereas those with all of the factors will have a score of 5. The index so developed is called Follicular Lymphoma International Prognostic Index (FLIPI).
FLIPI divides patients with follicular lymphoma into three groups:
- Low risk (no or one poor prognostic factor)
- Intermediate risk (two poor prognostic factors)
- High risk (three or more poor prognostic factors)
Follicular lymphoma is slow-growing cancer. People diagnosed with the disease may not find a cure but can still live for a long time with it.
How is follicular lymphoma treated?
Doctors usually apply the wait-and-watch approach for patients with follicular lymphoma.
Treatment is reserved for the following patients:
- Those whose lymph nodes are growing
- Those who have developed symptoms of the disease
- Those who have deranged blood tests
As per the stage, treatment options are as follows:
Stage I follicular lymphoma
Radiation is the most preferred treatment because it has the greatest chance of curing the disease. It involves projecting high-energy beams on the cancerous lymph nodes.
Stages II to IV follicular lymphoma
- Monoclonal antibodies:
- These drugs, given intravenously (IV), act like the body's disease-fighting cells (antibodies).
- This involves using pills or injections to destroy cancer cells in the body.
- This involves using antibodies to deliver radiation to the cancer cells.
- It is associated with many short-term and long-term side effects.
- Doctors recommend radioimmunotherapy only if the lymphoma returns after other therapies or does not respond to chemotherapy.
- Novel agents:
- Follicular lymphoma is most likely to come back in about 30 to 40 percent of patients, in which doctors employ novel agents in such cases.
- These drugs target specific cellular proteins or enzymes in the cancer cells.
- These newer medications differ from traditional chemotherapy drugs and can be used as initial therapy in a few selected patients.
- These include drugs belonging to the groups labeled proteasome inhibitors, histone deacetylase (HDAC) inhibitors, Bruton's tyrosine kinase (BTK) inhibitors, PI3K inhibitors, EZH2 inhibitors and nuclear export inhibitors.
- Stem cell transplant:
- Generally reserved for patients whose lymphoma has recurred after treatment, and is also called bone marrow transplantation of hematopoietic stem cell transplantation.
- It is a surgery that involves transplanting the cells that come from either the patient’s own stem cells or a donor's bone marrow into the patient’s bone marrow.
- Typically, chemotherapy is administered weeks before a stem cell transplant.
- Clinical trials:
- A study is performed on patients that aims to find the treatment for their particular condition.
- Patients with follicular lymphoma, particularly of stage II, III or IV, can consider enrolling in these trials.
- They can ask their healthcare provider for more information.
Follicular Lymphoma Management Overview. https://emedicine.medscape.com/article/203268-overview
Follicular lymphoma. https://rarediseases.info.nih.gov/diseases/2356/follicular-lymphoma
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