What therapy do you usually choose in patients with previously treated follicular lymphoma who experience early relapse (<2 years)?
My approach to POD24 patients is to first ensure there is no evidence of transformed disease. According to a retrospective analysis led by @Dr. First Last at Memorial Sloan Kettering, as many as 40% of the POD24 patients have evidence of transformed disease if a biopsy is pursued. Clinical indicator...
These are challenging cases. First, I try to find out whether these cases are transformed to DLBCL. In truly FL POD24, I try to enroll in a clinical trial. If no trial is available, my first choice is non chemo approach such as lenalidomide and rituximab. Sometimes, I consider lenalidomide obinutuzu...
In patients with previously treated follicular lymphoma who relapse early, within 2 years (POD 24), I usually treat this as high-risk biology, not routine indolent relapse. My default is to re-biopsy if there is any concern for transformation, then favor a more active immune-based approach rather th...
Early progression after frontline therapy, particularly POD24, identifies patients with biologically aggressive and relatively treatment-resistant disease and is associated with significantly worse long-term outcomes. I generally approach these patients differently from those who experience a late r...