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...

In patients with previously treated follicular lymphoma who experience early relapse (<2 years), which is recognized as a strong predictor of worse clinical outcome, I would first rebiopsy to rule out transformation. The approach depends on whether this is a first relapse (second line) or a subseque...

Agree with others that getting a biopsy is frequently helpful. My default treatment for these patients is Epcoritamab plus R2, which showed an unprecedented ORR of 95% (Merryman et al., ASCO 2023).

For older and/or less fit patients, Tafasitamab plus R2 can be considered. Adding Tafasitamab to R2 imp...