When would you consider treating an asymptomatic patient with follicular lymphoma?

The decision of when to initiate treatment of low-grade follicular lymphoma is, of course, part art and part science. It largely remains the standard of care to defer initiation of treatment when not required, but when is it required? The question identifies symptoms attributed to disease as a clear...

This is also challenging as there is not a lot of data. I consider treating asymptomatic patients with extranodal disease (bone disease is a frequent example) or those who relapsed as FL with a prior diagnosis of DLBCL.

Two options exist for the initial treatment of patients with asymptomatic advanced follicular lymphoma (FL): the watch-and-wait approach or immediate therapy. While there is a place for watch and wait and for immediate treatment, the question of whether to initiate treatment right away or watch and ...

I agree with many of the excellent responses to this question. For low tumor burden, in particular, I don't usually recommend treatment. However, I wanted to point out that SWOG has an open study comparing rituxan and mosunetuzumab in low tumor burden follicular lymphoma (S2308).