Modern approaches to the treatment of relapsed follicular lymphoma

Abstract

Follicular lymphoma is a tumor of mature B-lymphocytes, characterized by a predominantly indolent course. Despite advances in first-line therapy, disease relapses still occur, and with an increase in the follow-up period, the risk of transformation into diffuse large B-cell lymphoma also increases. The choice of a further anticancer therapy is based on the results of a comprehensive examination and repeated biopsy. In addition, previous remission duration, previous treatment, clinical manifestation of relapse, the patient's somatic condition and comorbidity are taken into account.  A clinical observation of a 57-year-old patient with relapsed follicular lymphoma, who received various chemotherapy regimens in combination with rituximab in the 1st and subsequent lines, is presented. After repeated biopsy and exclusion of transformation into diffuse large B-cell lymphoma, the patient received lenalidomide therapy in combination with obinutuzumab. A partial antitumor response after 4 cycles with decrease in tumor volume by more than 80 % by the end of induction was achieved. The absence of severe adverse events, together with a pronounced antitumor effect, significantly improved the patient's quality of life.