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Follicular Lymphoma Watch Wait — RACP Adult Medicine MCQ

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HardHaematologyFollicular Lymphoma Watch WaitRACP Adult Medicine

A 70-year-old has biopsy-proven low-grade follicular lymphoma, low tumour burden, no cytopenia, threatened organ or B symptom, and no rapid progression. What is the preferred initial strategy?

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Correct answer: EActive surveillance with scheduled clinical and laboratory review

The best answer is “Active surveillance with scheduled clinical and laboratory review”. Asymptomatic low-tumour-burden follicular lymphoma can be safely observed until accepted treatment indications develop; immediate therapy has not shown a survival advantage for this presentation. Review monitors symptoms, examination and blood counts. Intensive chemotherapy, transplant, chronic steroid and splenectomy expose the patient to substantial harm without a current treatment trigger.

Reference: eviQ: R-CVP for follicular lymphoma: https://www.eviq.org.au/haematology/lymphoma/other-b-cell-lymphoma/168-r-cvp-rituximab-cyclophosphamide-vincristine