Follicular Lymphoma

Follicular Lymphoma in brief

Follicular lymphoma is a common form of non-Hodgkin lymphoma and accounts for about 20–30 % of all cases. It mainly affects adults and usually occurs in middle to older age, with an average age at diagnosis of about 60 years. Women and men are affected equally. Because it is a slow-growing cancer, follicular lymphoma often goes undetected for years and is frequently discovered by chance.

Follicular lymphoma at a glance

Frequency

About 20–30 % of all non-Hodgkin lymphomas

Average age at diagnosis

About 60 years

Sex

Women and men affected equally

Growth

Slow-growing (indolent)

What exactly is follicular lymphoma?

Follicular lymphoma is a cancer that arises in the B cells of the lymphatic system. It forms in the lymph nodes and can spread to other organs. The term "follicular" refers to the pattern that the cancer cells form, which under the microscope looks like small vesicles or follicles. This type of lymphoma grows slowly and is therefore often only discovered at an advanced stage.

Why do I have follicular lymphoma?

The exact cause of follicular lymphoma is not fully understood. However, there are some risk factors that have been linked to the development of this disease. These include:

• older age,
• a family history of lymphomas as well as certain genetic changes,
• environmental factors such as radiation exposure, and
• a weakened immune system.

Symptoms of follicular lymphoma

Follicular lymphoma often causes no symptoms for a long time. When symptoms do occur, they may include:

• Swollen but painless lymph nodes (frequently in the neck, the armpits, or the groin)
• Fatigue
• Unintended weight loss
• Night sweats
• Fever
• Abdominal pain or a feeling of fullness (due to an enlarged spleen or lymph nodes in the abdomen)

When is follicular lymphoma treated?

Because follicular lymphoma grows slowly and many patients remain symptom-free for a long time, the disease is often observed at first. This strategy is called "watch and wait." Treatment is usually only started when symptoms occur or the lymphoma spreads and leads to complications. However, early treatment may be necessary in certain cases. These include, for example, very young patients or aggressive forms of the lymphoma.

How is follicular lymphoma treated?

The treatment of follicular lymphoma depends on the stage of the disease, the patient's general state of health, and individual factors. Treatment options include:

• Immunotherapy: Rituximab is a commonly used antibody therapy that acts specifically against the cancer cells.
• Chemotherapy: Often in combination with immunotherapy to destroy the cancer cells.
• Radiation therapy: Often used when the disease is limited.
• Radioimmunotherapy: A combination of radiation therapy and immunotherapy.
• Stem cell transplantation: In rare cases, for advanced or recurrent disease.
• Targeted therapy: New drugs that act specifically against certain molecules in the cancer cells.

How exactly have clinical trials changed the treatment landscape in lymphoma?

Clinical trials have significantly improved the treatment of follicular lymphoma. The introduction of immunotherapies, in particular rituximab, has considerably improved the prognosis and increased patients' quality of life. New approaches such as targeted therapies and combined treatment strategies have also enabled progress. These trials help to develop more effective and less toxic treatments and to improve long-term outcomes for patients.