Review of the Management of Relapsed/Refractory Follicular Lymphoma: An Italian Perspective

Abstract

Follicular lymphoma (FL) is an indolent disease characterized by multiple relapses and eventual refractoriness to therapy. Despite advancements in therapeutic approaches, FL treatment algorithm and management remain not well-established, necessitating both ongoing research into novel therapeutic strategies and in stating patient journey. We propose a comprehensive overview of current standard treatments for relapsed or refractory (R/R) FL, including chemoimmunotherapy and stem cell transplantation, and insights into emerging therapies such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies. We discuss the efficacy and safety profiles of these innovative treatments, their integration into the therapy armamentarium, and the potential they hold in altering the natural history of FL. Additionally, we propose a therapeutic flow depending on POD24 (i.e., progression of disease within 24 months), transformed disease, early relapse and fast/low progression, with the aim to provide a useful tool to all physicians dealing with this disease for achieving sustained remission and improving the quality of life in patients with R/R FL.