NCCN Guidelines for Patients® | Follicular Lymphoma Grade 1-2

38 NCCN Guidelines for Patients ® : Follicular Lymphoma, Grade 1–2, 2017 4 Treatment guide Typical type Treatment results Your doctor will assess if treatment is working. Imaging tests are used. There are four types of treatment response. These responses are described next. † † Complete remission is the best outcome. Lymph nodes and other organs are back to normal size. Cell metabolism is normal. † † Partial remission is a good response. The size of enlarged lymph nodes or other organs has been greatly reduced. Cell metabolism has slowed down. † † No response or stable disease is less than a partial remission. Enlarged nodes may be smaller but not by much. Cell metabolism is still fast. † † Progressive disease is a worsening of the cancer. Follow-up care is started if the lymphoma was fully or partly treated. If the lymphoma is the same or worse, read Stages III & IV for treatment options. Follow-up care Guide 5 lists the types of and schedule for follow- up care. However, follow-up care may be received whenever there are signs or symptoms of cancer. CT is the standard imaging test used during follow- up. Scans of your chest, abdomen, and pelvis with contrast are advised. PET/CT may clarify if a mass found by CT is cancer or just scar tissue. Progression The cancer might grow during follow-up care. If growth occurs, a biopsy is needed. The removed tissue will be tested to see if the type of cancer has changed. If follicular cancer is still present, read Stages III & IV for treatment options. Follicular lymphoma sometimes changes into diffuse large B-cell lymphoma. If it has, read the related NCCN Guidelines for Patients ® for chemotherapy options. Rituximab or involved-site radiation therapy may be added to chemotherapy. Other options may include ibritumomab tiuxetan, radiation therapy, a clinical trial, or supportive care only. Guide 5. Follow-up care Type of care How often is this care needed? Medical history and physical exam • Every 3–6 months for 5 years ◦◦ If normal, then repeat every year or when needed CBC, chemistry panel • Every 3–6 months for 5 years ◦◦ If normal, then repeat every year or when needed Imaging tests • Not more often than every 6 months for years 1 and 2 • Not more often than every year for year 3 and on

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