How is the patient's progress monitored with retroperitoneal non-Hodgkin's B-cell stage II follicular lymphoma?

From the Guidelines

Patients with retroperitoneal non-Hodgkin's B-cell stage 2 follicular lymphoma should be followed up with regular clinical evaluations every 3 to 6 months, determined by pretreatment risk factors and treatment response, with a focus on history, physical examination, and laboratory tests, rather than routine surveillance scans. The follow-up visits should include a thorough physical examination, assessment of disease-related symptoms, and laboratory monitoring with complete blood counts, comprehensive metabolic panels, and lactate dehydrogenase (LDH) levels at each visit 1. Imaging studies, such as CT scans, should be prompted by clinical indications, such as signs of disease progression or unexplained cytopenias, rather than performed routinely 1. This approach allows for early detection of disease recurrence or progression, enabling timely intervention while minimizing radiation exposure from frequent imaging studies. Key considerations in follow-up evaluations include:

• History and physical examination as the cornerstones of patient follow-up 1
• Laboratory monitoring with complete blood counts, comprehensive metabolic panels, and lactate dehydrogenase (LDH) levels at each visit 1
• Imaging studies, such as CT scans, should be performed only as clinically indicated, rather than routinely 1
• Limiting the number of scans to which a patient is exposed to minimize radiation exposure and unnecessary investigations 1. In the context of follicular lymphoma, which is considered an incurable histology, the likelihood of recurrence continues or increases over time, and patients should be observed regularly to monitor for disease progression and treatment-related adverse effects 1.

From the FDA Drug Label

The main outcome measure of the study was progression-free survival (PFS) defined as the time from randomization to the first of progression, relapse, or death. The PFS results based on investigator assessment of progression were similar to those obtained by the independent review assessment. The main outcome measure of the study was progression-free survival (PFS), defined as the time from randomization in the maintenance/observation phase to progression, relapse, or death, as determined by independent review

• Progression-free survival (PFS) is used to monitor the patient's progress.
• The patient's progress is monitored by assessing the time from randomization to the first of progression, relapse, or death.
• Independent review assessment and investigator assessment of progression are used to determine PFS. 2

From the Research

Patient Progress Monitoring

The patient's progress with retroperitoneal non-Hodgkin's B cell stage 2 Follicular lymphoma can be monitored through various methods, including:

• Regular follow-up appointments with the healthcare provider to assess symptoms and overall health 3, 4, 5, 6
• Imaging tests such as CT scans or PET scans to monitor the size and spread of the tumor 3, 4, 5, 6
• Blood tests to monitor blood cell counts and check for signs of cytopenias 3, 4, 5, 6
• Bone marrow biopsies to check for involvement of the bone marrow 3, 4, 5, 6

Prognostic Factors

The prognosis of Follicular lymphoma can be assessed using the Follicular Lymphoma International Prognostic Index (FLIPI), which takes into account five independent predictors of inferior survival:

• Age >60 years
• Hemoglobin <12 g/dL
• Serum LDH > normal
• Ann Arbor stage III/IV
• Number of involved nodal areas >4 3, 4, 5, 6 Other factors such as time to relapse and specific gene mutations may also be useful for prognosis 3, 4, 5, 6

Treatment Outcomes

The treatment outcomes for Follicular lymphoma have improved with the use of modern therapies, including:

• Chemoimmunotherapy, which has improved response rates, duration of response, and overall survival 3, 4, 5, 6
• Maintenance rituximab, which has shown additional benefit in randomized studies 3, 4, 5, 6
• Experimental therapies and stem cell transplantation, which are considered for recurrent disease 3, 4, 5, 6
• Novel antibodies against follicular non-Hodgkin's lymphoma, which are being developed to improve treatment outcomes 7