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

41 NCCN Guidelines for Patients ® : Follicular Lymphoma, Grade 1–2, 2017 4 Treatment guide Typical type Follow-up care Follow-up care is started if first-line treatment fully or partly treated the lymphoma. Guide 8 lists the types of and schedule for follow-up care. However, this 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 lymphoma might grow during follow-up care. If growth occurs, a biopsy is needed. The tissue will be tested to see if the type of cancer has changed. If follicular lymphoma is still present, you may be observed first and treated if the lymphoma worsens. If treatment is needed, read Guide 9 for 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. Guide 8. 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 I was very fortunate in that I did not have many side effects from my treatment. I took nausea meds for a few days, then was fine. Not much curtailing of activities. – Madeleine Survivor, Age 81 “

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