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

44 NCCN Guidelines for Patients ® : Follicular Lymphoma, Grade 1–2, 2017 4 Treatment guide Pediatric type Maintenance or consolidation Guide 10 lists options for maintenance or consolidation. These treatments may be received if second-line treatment fully or partly treated the lymphoma. Besides active treatment, observation is an option. Rituximab may be used as a maintenance treatment. It is received one time every 12 weeks for 2 years. If prior maintenance rituximab had little benefit, it likely won’t be helpful now. Instead, obinutuzumab may be used for maintenance. It is received one time every 8 weeks for 2 years. For consolidation, a stem cell transplant is an option. You must be fairly healthy to have this treatment. An autologous transplant is the more common type for follicular lymphoma. In some cases, an allogeneic transplant is an option. Pediatric type Guide 11 lists options for first-line treatment of pediatric subtype. This type is stage I. It often occurs in adults of younger age. However, it does sometimes occur in people older than 60 years. The outlook is often good. Excision is a type of surgery that removes the tumor and not much else. It is preferred by NCCN experts. Other options include radiation therapy or chemoimmunotherapy. Treatment results Your doctor will assess the cancer stage after radiation or chemotherapy. PET/CT is used. If there are no signs of the lymphoma, you can start follow- up care. Imaging is not needed for follow-up care. If signs of the lymphoma remain, read Typical type , Stages III & IV for treatment options. Guide 10. Maintenance or consolidation What are the options? • Rituximab • Autologous blood stem cell transplant • Allogeneic blood stem cell transplant • Obinutuzumab • Observation Guide 11. First-line treatment for pediatric type What are the options? • Excision • Involved-site radiation therapy • RCHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone)