Follicular lymphoma

Follicular lymphoma is a common type of slow-growing (low-grade) non-Hodgkin lymphoma that develops from B cells. It is called 'follicular' lymphoma because the ... Skiptocontent Donate Callourhelpline Home Aboutlymphoma Expanddropdown COVID-19andlymphoma Whatislymphoma? 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Lymphomaisatypeofbloodcancerthatdevelopswhenwhitebloodcellscalledlymphocytesgrowoutofcontrol.Lymphocytesarepartofyourimmunesystem.Theytravelaroundyourbodyinyourlymphaticsystem,andblood,helpingyoufightinfections.Therearetwotypesoflymphocyte:Tlymphocytes(Tcells)andBlymphocytes(Bcells). LymphomascanbegroupedasHodgkinlymphomasornon-Hodgkinlymphomas,dependingonthetypesofcelltheycontain.Follicularlymphomaisacommontypeofslow-growing(low-grade)non-HodgkinlymphomathatdevelopsfromBcells.Itiscalled‘follicular’lymphomabecausetheabnormalBcellsusuallydevelopinclumpscalled‘follicles’insidelymphnodes. ProfessorSimonRule,consultanthaematologist,andMaureen,whohasfollicularlymphoma,talkaboutlow-gradenon-Hodgkinlymphoma:whatitis,themostcommonsymptomsandhowitmightbetreated Backtotop Whogetsfollicularlymphomaandwhatcausesit? Follicularlymphomaisthemostcommontypeoflow-gradenon-Hodgkinlymphoma.About2,200peoplearediagnosedwithfollicularlymphomaeveryyearintheUK.Itcandevelopatanyage,butitismorecommoninpeopleover60. Inmostcases,thereisnoknowncauseforfollicularlymphoma.Somegeneticchangesarecommoninfollicularlymphoma,butscientistsdon’tknowwhatcausesthem.Thereisnotnormallyanyfamilyhistoryoffollicularlymphoma. Backtotop Symptoms Follicularlymphomaisusuallyveryslow-growingsosymptomsdevelopgraduallyovertime.Manypeoplehavefewsymptomsandsomehavenoneatall.Sometimesfollicularlymphomaisnoticedduringtestsforadifferenthealthissue.However,follicularlymphomacanbeveryvariableandsomepeoplemighthavefaster-growingfollicularlymphomathatcausesmoresymptoms. Themostcommonsymptomoffollicularlymphomaisalumporseverallumps.Thesetypicallydevelopinyourneckorjustaboveyourcollarbonesbuttheycandevelopinotherplaces,suchasyourarmpitsorgroin.Thelumpsarecausedbylymphomacellsbuildingupinyourlymphnodes,whichmakesthelymphnodesswell.Theswollenlymphnodesareusuallypainless.Theymightstayswollenortheymightshrinkalittleandthencomebackfromtime-to-time.Mostpeoplehavenoothersymptoms. Somepeoplehaveothercommonsymptomsoflymphoma,suchas: unexplainedweightloss fevers(temperatureabove38ºC) drenchingsweats,especiallyatnight frequentinfections,orhavingdifficultygettingoverinfections fatigue(overwhelmingtiredness). Weightloss,drenchingsweatsandfeversoftenoccurtogether.Thesethreesymptomsarecalled‘Bsymptoms’. Rarely,follicularlymphomaisfoundoutsideofthelymphnodes.Thisiscalled‘extranodal’lymphoma.Extranodallymphomacancauseavarietyofsymptomsdependingwherethelymphomaisgrowing. Around1in2peoplewithfollicularlymphomahavelymphomacellsintheirbonemarrow(thespongycentreoflargerboneswherebloodcellsaremade)whentheyarediagnosed.Thismightleadto: anaemia(lowredbloodcellcount),whichcancausetirednessandshortnessofbreath thrombocytopenia(lowplateletcount),whichmakesyoumorelikelytobruiseandbleed neutropenia(lowneutrophilcount–atypeofwhitebloodcell),whichmakesyoumorepronetoinfection. Backtotop Diagnosisandstaging Themainwaytodiagnosefollicularlymphomaistoremoveasampleofcellsfromyourbodyandlookatitunderamicroscope.Thisinvolvesaprocedurecalledabiopsy,whichisusuallydoneunderalocalanaesthetic.Youmighthavea‘needlecorebiopsy’,whenadoctorusesahollowneedletoremovea‘core’oftissuefromalymphnode.Sometimesawholelymphnodeneedstoberemoved.Thisinvolvesasmalloperation.Itisusuallyperformedunderlocalanaesthetic. Thebiopsysampleisexaminedbyanexpertlymphomapathologist.Thepathologistmightalsotestthelymphomacellsforparticularproteinsandgeneticchanges.Thiscanhelpyourmedicalteamdecideonthemostappropriatetreatmentforyou.   Ihadnoideawhatfollicularlymphomawas.Iwasinproperpanicmode –fearfulandhorrified.Mywife,Brenda,foundoutasmuchinformationasshecouldfromLymphomaAction,andinfactweweregivenoneofthecharity’sleafletsatthehospitalwhenIwasdiagnosed.Butitwasreallyhardformetotakeininformationatthatpoint.Yourbrain’sstillinshockIthink. Malcolm,diagnosedin2007Youalsohavebloodteststolookatyourgeneralhealth,checkyourbloodcellcounts,makesureyourkidneysandliverareworkingwell,andtestforviralinfectionsthatcouldreactivateduringtreatment. Youhaveotherteststofindoutwhichareasofyourbodyareaffectedbylymphoma.Thisiscalledstaging.StagingusuallyinvolveshavingaCTscanandoftenalsoaPETscan.Youmighthaveasampleofyourbonemarrowcellstaken(abonemarrowbiopsy),tocheckifyouhavelymphomacellsinyourbonemarrow. Youusuallyhaveyourtestsdoneasanoutpatient.Ittakesafewweekstogetalltheresults.Waitingfortestresultscanbeaworryingtime,butitisimportantforyourmedicalteamtohavealltheinformationtheyneedsotheycanplanthemostappropriatetreatmentforyou. Becausefollicularlymphomatypicallygrowsslowlyandmightnotcauseanysymptoms,itisoftenadvanced(stage3or4)bythetimeitisdiagnosed.Therearetreatmentsforallstagesoffollicularlymphoma,whichcanusuallykeepthelymphomaundercontrolformanyyears. ReadAndy'spersonalstory.   Inoticedadullacheinmygroinandfeltalump.Aftertests,ahaematologisttoldmeIhadfollicularB-cellnon-Hodgkinlymphoma,probablystage3.Amonthbefore,Ididn’tevenknowtherewasanythingwrongwithme,andnowIamdiagnosedwithastage3cancer.Howdoesthatwork? Andy,diagnosedin2009 Gradingoffollicularlymphoma Yourdoctormighttellyouthegrade(1,2,3Aor3B)aswellasthestageofyourlymphoma.Thegraderelatestothenumberoflargelymphocytesthatthepathologistcanseeunderamicroscope.Grade1hasthefewestlargelymphocytesandgrade3Bhasthemost.Grades1and2areoftengroupedtogether.Yourdoctormightcallthis‘grade1to2’follicularlymphoma. Grades1to2and3Afollicularlymphomaareallslow-growingandaretreatedinthesameway.Thegradedoesnotaffectthelikelyoutcomeoftreatment. Grade3Bfollicularlymphomaisusuallyfast-growing.Underamicroscope,itlookslikeatypeofhigh-gradenon-HodgkinlymphomacalleddiffuselargeB-celllymphoma(DLBCL).ItistreatedthesamewayasDLBCL. Your‘prognosticscore’ Yourdoctormightuseyourtestresultstogiveyouascorethatcanhelppredictyourresponsetotreatment.Thisiscalleda‘prognosticscore’.Thereareanumberofdifferentscoringsystemsforfollicularlymphoma.OneofthemostcommonintheUKisthe‘FLIPI’,whichgivesyouascorebasedon: yourage howwidespreadyourlymphomais theresultsofsomeofyourbloodtests. Otherscoringsystemsarebasedontheparticulargeneticchangesyourlymphomacellshave. Yourdoctormightuseyourprognosticscoretohelpdecideonthemostappropriatetreatmentforyou. Backtotop Typesoffollicularlymphoma Mostpeoplewhohavefollicularlymphomadonothaveaparticulartype.However,therearesomerarevariantsoffollicularlymphomathatbehave,andaretreated,differently.Theseinclude: duodenal-typefollicularlymphoma paediatric-typefollicularlymphoma. Wehaveseparateinformationonprimarycutaneousfolliclecentrelymphoma.Thisisatypeoflow-gradeB-cellskinlymphomathatusedtobeclassifiedasatypeoffollicularlymphoma. Duodenal-typefollicularlymphoma Duodenal-typefollicularlymphomagrowsinthesmallintestine(smallbowelorgut).Itisslow-growingandisusuallydiagnosedatanearlystage.Duodenal-typefollicularlymphomaisunlikelytospreadtootherpartsofyourbodyorchange(transform)intoafaster-growingtypeoflymphoma.Peoplewithduodenal-typefollicularlymphomamightbeobserved(activemonitoring),treatedwithrituximab(onitsownorwithchemotherapy)ortreatedwithradiotherapy.Treatmentisusuallyverysuccessful. Paediatric-typefollicularlymphoma Paediatric-typefollicularlymphomaisaveryrareformoffollicularlymphoma.Ittypicallyaffectschildrenbutitoccasionallydevelopsinadults.Itismorecommoninmalesthanfemales. Paediatric-typefollicularlymphomamostcommonlydevelopsinlymphnodesintheheadorneck.Itistypicallydiagnosedatanearlystageandisusuallycuredwithtreatment.Mostpeoplehavesurgerytoremovetheaffectedlymphnodes.Occasionally,somepeopleneedradiotherapyorchemotherapy.Paediatric-typefollicularlymphomadoesnotusuallycomeback(relapse)aftersuccessfultreatment. Backtotop Outlook Follicularlymphomaoftengrowsslowly,althoughinsomepeopleitcandevelopmorerapidly.Treatmentisgenerallysuccessful,butatsomepoint,thelymphomausuallycomesback(relapses)andneedsmoretreatmenttokeepitundercontrol.Itishardtopredicthowlongitmightbebeforeyouneedmoretreatment. Mostpeoplelivewithfollicularlymphomaformanyyears.Youmighthaveperiodswhenyoufeelwellanddon’tneedtreatment,andotherperiodswhenyoursymptomsgetworseandyouneedmoretreatment. Yourdoctorisbestplacedtoadviseyouonyouroutlook(prognosis)basedonyourindividualcircumstances. Transformation Sometimes,follicularlymphomachanges(transforms)intoafaster-growingtypeoflymphoma.Thishappensinaround2to3inevery100peoplewithfollicularlymphomaeachyear. Ifyourdoctorthinksyourlymphomamighthavetransformed,youarelikelytohaveabiopsytocheckforfaster-growingcells.Transformedfollicularlymphomaisusuallytreatedlikeahigh-gradelymphomasuchasdiffuselargeB-celllymphoma(DLBCL). Backtotop Treatment Follicularlymphomaisslow-growingandthereisrarelyanurgentneedfortreatment.Somepeoplemightnotneedtreatmentformanyyears.Yourmedicalteamwillconsidercarefullywhetheryouneedtreatmentstraightawayandwhattreatmentisbestforyou. Thetreatmentyourmedicalteamrecommendsforyoudependsonthestageofyourlymphomaandthesignsandsymptomsyouhave.Stage1orstage2follicularlymphomaisknownas‘early-stage’lymphoma.Stage3orstage4follicularlymphomaisknownas‘advanced-stage’lymphoma.Mostpeoplehaveadvancedstagefollicularlymphomawhentheyarediagnosed. Whenchoosingyourtreatment,yourteamalsotakesintoaccount: whereyourlymphomaisgrowing howbigthelumpsoflymphomaare howthelymphomaisaffectingyou,includinganysymptomsyou’reexperiencingandtheresultsofyourbloodtests yourgeneralhealthandfitness yourage yourfeelingsabouttreatment. Yourteamalsoconsidersanypotentialsideeffects,long-termorlateeffects(healthproblemsthatdevelopmonthsoryearsaftertreatment)ofthetreatment. Treatmentofearly-stagefollicularlymphoma Around1in5peoplewithfollicularlymphomaarediagnosedwhenitisatanearlystage.Early-stagefollicularlymphomathatisonlygrowinginonepartofyourbodycansometimesbeveryeffectivelytreatedwithradiotherapytotheaffectedarea.Somepeoplemightevenbecuredwiththisapproach.Lowdosesofradiotherapyhavefewsideeffects. Sometimesradiotherapyisnotsuitable–forexample,ifyourlymphomaisclosetoimportantorgansthatcouldbedamagedbytheradiotherapy,orifyouhaveothermedicalconditionsthatmakeradiotherapyunsuitable.Ifthisisthecase,andyouarenotexperiencingtroublesomesymptoms,youmightnotneedtreatmentstraightaway.Instead,youmightbemonitoredduringregularvisitstoyourdoctor.Thisiscalledactivemonitoringor‘watchandwait’.Thisapproachkeepstreatmentforwhenitisneededandallowsyoutoavoidthesideeffectsoftreatmentforaslongaspossible.Alternatively,youmighthaveantibodytherapywithrituximabonitsown,oryoumightbetreatedinthesamewayaspeoplewithadvanced-stagefollicularlymphoma. Treatmentofadvanced-stagefollicularlymphoma Mostpeoplehaveadvanced-stagefollicularlymphomawhentheyarediagnosed.Advanced-stagefollicularlymphomacanbetreatedverysuccessfully.Treatmentaimstokeepthelymphomaundercontrolforaslongaspossiblewithasfewsideeffectsaspossible.Althoughthelymphomausuallycomesback(relapses)andneedsmoretreatmentatsomepoint,mostpeoplewithfollicularlymphomahavelongperiodsoffeelingwellbetweencoursesoftreatment. Ifyouhaveadvanced-stagefollicularlymphomathatisnotcausingtroublesomesymptoms,youmightnotneedtreatmentstraightaway.Instead,yourdoctorsmightrecommendanapproachcalled‘activemonitoring’(or‘watchandwait’).Thisinvolveshavingregularcheck-upswithyourmedicalteamtomonitoryourhealthandtoseehowthelymphomaisaffectingyou.Activemonitoringmeansthatwhileyouarewell,youavoidthesideeffectsofchemotherapyforaslongaspossible.Treatmentisstillavailablewhenyouneedit,butthismightnotbeformonthsoryears.Evenifyoudon’thaveanysymptoms,yourmedicalteammightrecommendashortcourseofanantibodytreatment(forexamplerituximab).Thiscanhelptodelayyourneedforchemotherapy. Louizetalksaboutherexperienceofactivemonitoringfollowedbychemotherapyforfollicularlymphoma Ifyourlymphomaiscausingproblems,yourmedicalteamarelikelytorecommendacourseofchemotherapycombinedwithantibodytherapy.Thisissometimescalledchemo-immunotherapy.   Iwasdiagnosedwithstage4follicularlymphomaandhadsixcyclesofR-CHOPchemotherapy.IthinkIhadpreparedmyselfforahorribleexperience,so,althoughIfeltqueasyattimes,treatmentwasn’tasbadasIhadexpected.IhadbeenwarnedthatIwouldlosemyhair,butthiswasn’tsomethingIreallyworriedabout–infact,IhavemorehairnowthatithasgrownbackthanIdidbefore. Douglas,diagnosedin2010 Themostcommonchemotherapyregimens(combinationsofdrugs)usedtotreatfollicularlymphomaare: bendamustine CVP–cyclophosphamide,vincristineandprednisolone CHOP–cyclophosphamide,doxorubicin(alsoknownashydroxydaunorubicin),vincristine(alsoknownasOncovin®)andprednisolone) chlorambucil. Theyareusuallygivenwithantibodytherapy.Atthetimeofwriting,twoantibodytherapiesareavailabletotreatfollicularlymphomaintheUK: rituximab–inwhichcasean‘R’isaddedtothenameofyourchemotherapyregimen(forexampleR-CHOP) obinutuzumab–inwhichcasean‘O’isaddedtothenameofyourchemotherapyregimen(orsometimesa‘G’,afterthetradenameofobinutuzumab:Gazyvaro®). Ifyourespondwelltoyourcourseofchemo-immunotherapy,youarelikelytobeofferedmaintenancetreatment.Thisaimstokeepyourlymphomaundercontrolandmakeyourremission(thetimewhenyourlymphomahasshrunkorgonecompletely)lastaslongaspossible.Maintenancetreatmentinvolveshavinganinjectionofyourantibodytherapy(eitherrituximaborobinutuzumab)every2monthsforupto2years.   Inretrospect,IampleasedthatIdidnotknowanythingaboutthesideeffectsofmychemotherapy.IwasawarethatImightfeelsickbut,surprisingly,Ineverdid.Astheweeksprogressedthough,my‘dip’daysbecameharderalongsidethefatigue,theachinginmybones,thelossofappetiteandmostofallthemouthblisters.Ineverrealisedhowdifficultitistokeepyourtonguestill...Icanreflectnowabouthowharditwas,particularlythelasttwocycles,andIaminaweofmyselfandhowImanagedtosurvive,letalonemanagetosmileoccasionally!Itisaverydifficultthingtogothroughinsomanywaysbuthavingwonderfulsupport,bothmedicalandathome,waskeytokeepingmegoing. Debbie,diagnosedin2010 Backtotop Follow-up Ifyouareonactivemonitoring(watchandwait)oryou’reinremissionaftertreatment,you’llhaveregularfollow-upappointmentsintheclinic.Yourfollow-upappointmentsaretocheckthat: youarerecoveringwellfromtreatment youhavenosignsofthelymphomarelapsingorgettingworse youarenotdevelopinganylateeffects(sideeffectsthatdevelopmonthsoryearsaftertreatment). Ateachappointment,yourdoctorornursespecialistexaminesyouandasksifyouhaveanyconcernsorsymptoms.Youmighthavebloodtests.Youareunlikelytohaveascanunlessyouhavetroublingsymptoms. Somepeoplegoontoaself-managementscheme.Yourmedicalteamgivesyouinformationonwhattolookoutforandhowtobookanappointmentifyouneedone.YoumighthavebloodtestsatyourGPsurgery.Ifyouareworriedaboutyourhealthatanytime,youcancontactyourmedicalteam.     Mylastchemotherapywas13yearsagoandcheck-upsarenowannual.Ihavebeenlymphomafreefor13yearsandhavedonethingsIcouldbarelyhavedreamedofdoingbeforeIwasdiagnosed.Irealisehowgettingolderreallyisaprivilege,andIamsogratefulforbeingabletolookforwardtothenextstageinmylife. Caroline,diagnosedin2006ReadCaroline'spersonalstory. Backtotop Relapsedorrefractoryfollicularlymphoma Treatmentforfollicularlymphomaisusuallyeffective.However,follicularlymphomausuallycomesback(relapses)andneedsmoretreatmentatsomepoint.Mostpeoplewithfollicularlymphomaneedseveralcoursesoftreatmentduringtheirillness. Thelengthofremissionaftersuccessfultreatmentcanvarywidely,soitcanbedifficulttopredicthowlongitmightbebeforeyouneedmoretreatment.Somepeoplestayinremissionforseveralyearsbutothersneedmoretreatmentsooner.   Adiagnosisisn’tnecessarilyasbadasitmayseematfirst.SincebyallaccountsIshouldnothavehadthistypeatayoungageIfeelveryluckythateachtimeithasrelapsednewtreatmentswereofferedandthatmanyyearslaterIamabletotellmystory. Carole,diagnosedin1984 Occasionally,lymphomadoesn’trespondwelltoyourfirsttreatment.Thisiscalled‘refractory’lymphoma.Refractorylymphomaisusuallytreatedinasimilarwaytorelapsedlymphoma. Ifyouhavefollicularlymphomathatcomesback,youmighthavethesamesymptomsyouhadbeforeoryoumighthavedifferentsymptoms.Ifyourmedicalteamsuspectsyourlymphomahascomeback,theyarelikelytorecommendthatyouhaveanotherbiopsytomakesureithasnotchanged(transformed)toafaster-growingtypeoflymphoma.Youarealsolikelytohavemorescanstocheckthestageofyourlymphoma. Treatmentforrelapsedorrefractoryfollicularlymphoma Ifyourlymphomaisnotcausingtroublesomesymptoms,youmighthaveaperiodofactivemonitoring(watchandwait)beforestartinganytreatment.Ifyouneedtreatment,severaldifferentoptionsareavailableforrelapsedandrefractoryfollicularlymphoma.Yourmedicalteamwillconsiderallofthesamefactorstheyconsideredbeforeaswellas: thetreatmentyou’vealreadyhad howwellyourlymphomarespondedtoprevioustreatment howyoucopedwithyourprevioustreatment howquicklyyourlymphomarelapsed. Yourmedicalteammightdiscussseveraltreatmentoptionswithyou.Youshouldhavetimetoconsidertheoptionscarefullyanddiscusstherisksandbenefitswithyourteamtohelpyoudecidewhattreatmentisbestforyou.Weoutlinesomeofthemorecommonapproachesherebutyourmedicalteammightrecommendadifferentoption. Ifyouhavenothadrituximabaspartofyourtreatmentbefore,oryouhadalongremissionafterrituximab-basedtreatment,youmighthaverituximabagain,combinedwithchemotherapy.Thismightbethesamechemotherapyregimenyouhadbefore,oradifferentone.Ifyouhavenothadmaintenancetherapybefore,youmighthaveacourseofrituximabmaintenancetherapyafterwards. Ifyouhavehadrituximabaspartofyourtreatmentbeforebutyoudidnotrespondtoit,oryourelapsedwithin6monthsofhavingit,youmightbeofferedobinutuzumabplusbendamustine,followedbyobinutuzumabmaintenancetherapy. Youmighthavetreatmentwithrituximabcombinedwithatargeteddrugcalledlenalidomide(alsoknownasRevlimid®).ThiscombinationissometimescalledR2. Ifyourlymphomahasrelapsedmorethanonce,youmightbeofferedtreatmentwithatargeteddrugcalledidelalisib.Atthetimeofwriting,idelalisibisavailableontheNHSinScotlandbutitisnotcurrentlyavailableontheNHSinotherpartsoftheUKexceptaspartofaclinicaltrial. Ifyourespondwelltomoretreatment,yourmedicalteammightrecommendastemcelltransplanttohelpyourremissionlastaslongaspossible.Stemcelltransplantsareaveryintensiveformoftreatmentandyouhavetobefitenoughtohaveone. Ifchemotherapyortargetedtherapyisn’tsuitableforyou,yourmedicalteammightsuggestthatyouhaverituximabonitsown. Ifyourlymphomaiscausingproblemsinoneparticularareaofyourbody,youmightbeofferedradiotherapytotheaffectedareatohelpcontrolyoursymptoms. Backtotop Researchandtargetedtreatments Scientistsaretestingmanydifferenttargetedtreatmentsinclinicaltrialsforfollicularlymphoma,includingsometreatmentsthatarealreadyapprovedforothertypesoflymphoma.Manyofthesenewtargeteddrugsworkbyhelpingyourownimmunesystemgetridofthelymphoma.Theymightofferthepossibilityofmorechemotherapy-freetreatmentsinthefuture.   Itwasclearlyexplainedtomethatthedrugwasbeingtrialledandthatitwasimpossibletoknowatthatstageifitwasthebestcourseoftreatment,althoughtheclinicalteamseemedtothinkitwouldbe.Buttheystressedithadtobemydecision.AlthoughtheinformationIwasgivenwaseasyenoughtoreadandunderstand,ItookittomyGPtodiscuss.Shepointedoutthatmyprogresswouldbewellmonitored,intermsofthenumberofcheck-ups,bloodtestsandopportunitiestoseethetreatingteam. Sue,diagnosedin2007.Sheexperiencedarelapsein2010andhadtreatmentaspartofaclinicaltrialNewtypesoftreatmentthatarebeingtestedinpeoplewithfollicularlymphomainclude: Newantibodytherapies,includingantibodiesthatbindtotwodifferenttargets(oneonlymphomacellsandoneonTcells,whichhelpstheTcellsfindanddestroythelymphomacells).Thesearecalled‘bispecific’antibodies. Antibody–drugconjugates(antibodiesjoinedtochemotherapydrugs).Theantibodystickstoaproteinonthesurfaceoflymphomacellsandcarriesthechemotherapydrugdirectlytoit. Checkpointinhibitors,whichstoplymphomacellsblockingthepathwaysyourimmunesystemusestorecogniseanddestroycancercells. Cellsignalblockers,whichblocksignalsthatBcellssendtohelpthemdivideorstayalive.CellsignalblockersincludetargeteddrugssuchasBTKinhibitors,PI3KinhibitorsandBCL-2inhibitors,namedaftertheparticularproteinstheyblock. CART-celltherapy,whichinvolvesgeneticallymodifyingyourownTcellssotheycanrecogniseandkilllymphomacells. Drugsthatblockproteinslinkedtoparticulargeneticchangesinlymphomacells. Someofthesemightbeavailabletoyouthroughaclinicaltrial.Ifyouareinterestedintakingpartinaclinicaltrial,askyourdoctorifthereisatrialthatmightbesuitableforyou.Tofindoutmoreaboutclinicaltrialsortosearchforatrialthatmightbesuitableforyou,visitLymphomaTrialsLink. Backtotop Signuptoreceiveourmagazine JoinourFacebookSupportGroup TweettoTwitter(opensinanewwindow) ShareonFacebook(opensinanewwindow) Typesoflymphoma Lymphomainchildrenandyoungpeople Hodgkinlymphoma Non-Hodgkinlymphoma DiffuselargeB-celllymphoma Follicularlymphoma Mantlecelllymphoma Burkittlymphoma MALTlymphoma(gastricandnon-gastric) Nodalmarginalzonelymphoma Splenicmarginalzonelymphoma T-celllymphomas LymphoplasmacyticlymphomaandWaldenström’smacroglobulinaemia Chroniclymphocyticleukaemia(CLL) Skinlymphoma CNSlymphoma Otherrarehigh-gradeB-celllymphomas Post-transplantlymphoproliferativedisorder LymphomaandHIV Transformationoflymphoma Details Lastreviewed August2020 Nextplannedreview August2023 Downloads Follicularlymphomainformationsheet(PDF)(PDF,534.33KB)(Opensinanewtab) Low-gradenon-Hodgkinlymphomabook(PDF,8.5MB)(Opensinanewtab) Acknowledgements DrKiritArdeshna,DivisionalClinicalDirectorforCancerandConsultantHaematologistatUniversityCollegeHospitalLondon,forreviewingthisinformation. DrWilliamTownsend,ConsultantHaematologistandLeadforEarlyPhaseLymphomaTrials,UniversityCollegeLondonHospitalsNHSTrust,forreviewingthisinformation.DrTownsendhasreceivedhonorariaandconsultancyfeesfromRocheandGilead. WewouldalsoliketothankthemembersofourReaderPanelwhogavetheirtimetoreviewthisinformation. Signuptoreceiveourmagazine JoinourFacebookSupportGroup Wasthispageuseful? Sendusyourfeedback Whatislymphoma? Stagingoflymphoma Activemonitoring('watchandwait') Antibodytherapy Chemotherapy Radiotherapy Targeteddrugsforlymphoma Sideeffectsoflymphomatreatment Livingwithandbeyondlymphoma Glossary Readthepersonalstoriesofpeopleaffectedbyfollicularlymphomaandothertypesoflymphoma. Ifyouwouldlikefurtherinformationorwouldliketotalkaboutanyaspectofyourlymphoma,pleasecontactus. Findoutmoreaboutclinicaltrialsandsearchforatrialthatmightbesuitableforyou.