Newly diagnosed and relapsed follicular lymphoma: EHA Clinical Practice Guidelines for diagnosis, treatment, and follow-up.
20 affiliations
- 1Dipartimento di Medicina of Traslazionale Università del Piemonte Orientale Alessandria Italy.
- 2IRCCS, Azienda Ospedaliero-Universitaria Santi Antonio e Biagio e Cesare Arrigo Alessandria Italy.
- 3Lymphoma Coalition Ontario Canada.
- 4ELLyE - Patient Organization Paris France.
- 5Department of Radiation Oncology University Hospital of Heidelberg Heidelberg Germany.
- 6Department of Pathology University Hospital Schleswig-Holstein Kiel Germany.
- 7University of Helsinki and Helsinki University Hospital Helsinki Finland.
- 8Division of Cancer Sciences The University of Manchester and The Christie NHS Foundation Trust Manchester United Kingdom.
- 9Department of Hematology Hospital Clínic de Barcelona Barcelona Spain.
- 10Hematology Azienda USL IRCCS of Reggio Emilia Reggio Emilia Italy.
- 11CHIMOMO Department University of Modena and Reggio Emilia Reggio Emilia Italy.
- 12Centre Hospitalier Universitaire (CHU) Lille, Université de Lille, Groupe de Recherche sur les Formes Injectables et les Technologies Associées (ULR 7365-GRITA) Lille France.
- 13Centre for Haemato-Oncology, Barts Cancer Institute Queen Mary University of London London United Kingdom.
- 14Maria Sklodowska-Curie National Research Institute of Oncology Warsaw Poland.
- 15Université Paris Cité & Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Hemato-oncologie Paris France.
- 16Department of Hematology Amsterdam UMC, Location VUmc Amsterdam The Netherlands.
- 17First Faculty of Medicine, Charles University Hospital Prague Czech Republic.
- 18Concord Repatriation General Hospital University of Sydney Sydney New South Wales Australia.
- 19Department of Internal Medicine, Division of Hematology Istanbul University - Cerrahpaşa, Cerrahpaşa Medical Faculty Istanbul Türkiye.
- 20Department of Medicine III LMU University Hospital Munich Germany.
Abstract
Follicular lymphoma (FL) is the second most common lymphoma subtype in Europe, with a median age at diagnosis of 60-65 years. It is generally considered an indolent disease, and the median overall survival at diagnosis now likely exceeds 20 years. However, considerable heterogeneity exists. Diagnosis requires adequate biopsy material and a specialized hematopathologist. Staging and prognosis rely on positron emission tomography (PET)-computed tomography (CT). Prognostication at diagnosis is based on several validated clinical prognostic scores. Localized disease is usually treated with radiotherapy ± Rituximab. The treatment of disseminated disease includes active surveillance (or in selected cases Rituximab monotherapy) for low-tumor burden patients, and most often immunochemotherapy (or in selected cases chemo-free therapeutic options), ±antibody maintenance in high-tumor burden patients. For relapsed or refractory disease, treatment with Rituximab-Lenalidomide combination ± Tafasitamab or Epcoritamab from the first relapse and single-agent bispecific antibodies, chimeric antigen receptor T-cell therapy (CAR-T) cells, and Zanubrutinib-Obinutuzumab after second relapse should be prioritized over immunochemotherapy. Given the long natural history and risk of relapse, careful follow-up is an important part of patient management. Patients should be actively involved in decision-making. In this guideline, we present current evidence-based recommendations for diagnosis, staging, treatment, and follow-up.
Related
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BibTeX
@article{ladetto2026newly,
title = {{Newly diagnosed and relapsed follicular lymphoma: EHA Clinical Practice Guidelines for diagnosis, treatment, and follow-up.}},
author = {Marco Ladetto and Natacha Bolaños and Guy Bouguet and Klaus Herfarth and Wolfram Klapper and Sirpa Leppa and Kim Linton and Armando Lopez-Guillermo and Stefano Luminari and Franck Morschhauser and Jessica Okosun and Ewa Paszkiewicz-Kozik and Catherine Thieblemont and Sanne Helene Tonino and Marek Trneny and Judith Trotman and Umut Yilmaz and Martin Dreyling},
journal = {HemaSphere},
year = {2026},
month = oct,
doi = {10.1002/hem3.70507},
url = {https://europepmc.org/article/MED/42903357},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Newly diagnosed and relapsed follicular lymphoma: EHA Clinical Practice Guidelines for diagnosis, treatment, and follow-up.
AU - Marco Ladetto
AU - Natacha Bolaños
AU - Guy Bouguet
AU - Klaus Herfarth
AU - Wolfram Klapper
AU - Sirpa Leppa
AU - Kim Linton
AU - Armando Lopez-Guillermo
AU - Stefano Luminari
AU - Franck Morschhauser
AU - Jessica Okosun
AU - Ewa Paszkiewicz-Kozik
AU - Catherine Thieblemont
AU - Sanne Helene Tonino
AU - Marek Trneny
AU - Judith Trotman
AU - Umut Yilmaz
AU - Martin Dreyling
PY - 2026
DA - 2026/10/19
JO - HemaSphere
DO - 10.1002/hem3.70507
UR - https://europepmc.org/article/MED/42903357
AB - Follicular lymphoma (FL) is the second most common lymphoma subtype in Europe, with a median age at diagnosis of 60-65 years. It is generally considered an indolent disease, and the median overall survival at diagnosis now likely exceeds 20 years. However, considerable heterogeneity exists. Diagnosis requires adequate biopsy material and a specialized hematopathologist. Staging and prognosis rely on positron emission tomography (PET)-computed tomography (CT). Prognostication at diagnosis is based on several validated clinical prognostic scores. Localized disease is usually treated with radiotherapy ± Rituximab. The treatment of disseminated disease includes active surveillance (or in selected cases Rituximab monotherapy) for low-tumor burden patients, and most often immunochemotherapy (or in selected cases chemo-free therapeutic options), ±antibody maintenance in high-tumor burden patients. For relapsed or refractory disease, treatment with Rituximab-Lenalidomide combination ± Tafasitamab or Epcoritamab from the first relapse and single-agent bispecific antibodies, chimeric antigen receptor T-cell therapy (CAR-T) cells, and Zanubrutinib-Obinutuzumab after second relapse should be prioritized over immunochemotherapy. Given the long natural history and risk of relapse, careful follow-up is an important part of patient management. Patients should be actively involved in decision-making. In this guideline, we present current evidence-based recommendations for diagnosis, staging, treatment, and follow-up.
SN - 2572-9241
ER -