Reassessing the standard of care in indolent lymphoma: a clinical update to improve clinical practice.

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BlankReassessing the standard of care in indolent lymphoma: a clinical update to

improve clinical practice.

M Rummel

J Natl Compr Canc Netw, September 1, 2010; 8 Suppl 6: S1-14; quiz S15.

Department for Hematology and Medical Oncology, Justus-Liebig University

Hospital, Giessen, Germany.

Non-Hodgkin's lymphoma (NHL) represents a diverse group of hematologic

malignancies originating in B or T lymphocytes. Approximately 85% of NHLs are of

B-cell origin, with the remainder mostly of T-cell origin. The most common NHL

types are diffuse large B-cell lymphoma (31%) and follicular lymphoma (22%).

More than 65,000 new cases of NHL develop each year, and approximately 20,000

people with NHL died of the disease 2009. NHL is the seventh most common cancer

in the United States, contributes to approximately 4% to 5% of all cancer cases

in the United States, and causes approximately 3% of all cancer-related deaths.

Currently, nearly 500,000 people are living with the disease or are in

remission. Several new and encouraging advances have been made in the treatment

of indolent NHL. Although the watch and wait approach still has a role, combined

immunochemotherapy remains the standard of care for both first-line and

relapsed/refractory disease. As front-line treatment, bendamustine plus

rituximab may become a new standard of care, especially for older patients. In

contrast, rituximab in combination with chemotherapy followed by rituximab

maintenance seems to be the optimal option in patients with relapsed disease.

PMID: 20876549