Follicular lymphoma: Have we made any progress?

Follicular lymphomas are characterized by relatively long median survivals and a continuous pattern of relapse. The heterogeneity in these diseases is increasingly appreciated, leading to concerted efforts to define prognosti c factors and risk-adapted strategies. The status of multiple options for t reatment including interferon, fludarabine, dose intensification with autol ogous transplantation, therapy targeting the CD20 antigen and novel approac hes is reviewed. The long natural history of follicular lymphoma requires m ature data for accurate analysis. However, the achievement of molecular rem ission as a surrogate endpoint is under active investigation. This is an ex citing era for the clinical investigation of follicular lymphoma given the large number of candidate therapies and their potential combinations and pe rmutations. Although the goal of primary treatment remains durable remissio n and cure, the sequential application of effective, non-cross-resistant tr eatments may also result in a prolongation of median survival time. It is e ssential that physicians treating patients with follicular lymphoma demonst rate restraint in the application of new treatments and cooperate in the st udy of new therapies in carefully designed phase II and phase III trials.