What Is Follicular Lymphoma?
Follicular lymphoma (FL) is the second most frequent non-Hodgkin lymphoma subtype (NHL). It is caused by malignant B-cells, which are white blood cells. It is the most prevalent kind of slow-growing or low-grade lymphoma. Some people may not require therapy. However, others may have severe lymph nodes or organ involvement and require immediate treatment. They usually begin in the lymph nodes, although they can also begin in extranodal locations and regions other than the lymph nodes, such as the gastrointestinal tract. The majority of persons with follicular lymphoma will have bone marrow involvement.
Patients with follicular lymphoma may experience fever, night sweats, and weight loss. Some people exhibit no symptoms or indications of the condition. Most patients must begin treatment soon after being diagnosed. Treatments might vary depending on several criteria, including the patient's age, weight, severity, and existing symptoms. Relapse is more likely to occur within the first two years following therapy.
What Is Refractory or Relapsed Follicular Lymphoma?
Relapsed lymphoma is a type of lymphoma that returns after therapy and a period of recovery.
It does not react favorably to the initial therapy option. Being diagnosed with refractory lymphoma or having a recurrence can be very stressful. However, many patients have been effectively diagnosed and treated again and go into recovery. In general, relapsing lymphoma and refractory lymphoma are treated with the same alternatives.
If lymphoma cells remain in the body after therapy, relapse may occur. In addition, these cells might progressively accumulate and cause issues again. In some situations, if received a partial remission, there might be a reduction in the size of lymphoma during treatment but never wholly reduced. Some patients who have had a full recovery and show no indication of lymphoma during the tests and scans following therapy may also suffer a return. It is because there may still be a small number of lymphoma cells that are undetectable by routine diagnostics. Some lymphoma kinds are more likely to reoccur than others.
What Are the Symptoms of Refractory or Relapsed Follicular Lymphoma?
Some patients with follicular lymphoma show no symptoms at all. Several symptoms are not unique to lymphoma and are found in various diseases. People frequently go to the physician because they believe they have a cold, flu, or another respiratory infection that is not disappearing. The first symptom of follicular lymphoma is painless swelling of the lymph nodes. It usually affects the lymph nodes surrounding the underarms, neck, groin, and abdomen.
Other follicular lymphoma symptoms include:
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Fatigue.
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Unexpected weight loss.
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Frequently occurring infections.
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Lymph node swelling, which may or may not be painful.
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Fever and chills.
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Sweating (often at night).
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Itching.
Most persons with these vague symptoms do not have lymphoma. However, anyone experiencing chronic symptoms must ensure that lymphoma is not present.
How Is Relapsed or Refractory Lymphoma Diagnosed?
An accurate diagnosis is one of the most crucial components of a patient's care. A correct diagnosis will assist the physician in estimating the rate of illness development and in determining the best course of action. Initially, the doctor will do a physical examination and take a medical history.
The size of lymph nodes is measured during the physical examination. In addition, the following tests are done to detect the condition.
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Biopsy of Lymph Nodes- A lymph node biopsy includes extracting a tiny piece of tissue from a lymph node or, in some instances, the entire lymph node and examining the sample to determine whether it is cancerous.
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Blood Test- Blood testing can determine the amount and shape of the blood cells.
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Imaging Test- It is done to detect lymphoma in the body and arrange for therapy. It is typical to utilize a CT (computed tomography) scan, a PET (positron emission tomography) scan, or a PET (positron emission tomography) / CT (computed tomography) scan that combines both modalities.
What Are the Treatments for Refractory or Relapsed Follicular Lymphoma?
After the previous treatment, treatment for relapsed or refractory follicular lymphoma is determined by a patient's age, overall health, symptoms, and length of remission. Relapsed or refractory follicular lymphoma may be treated with chemotherapy, radiotherapy, monoclonal antibodies, and chimeric antigen receptor (CAR) T cell treatment. Second-line regimens often used include:
1. Radiation: Radiation destroys cancer cells by using high-energy beams. It is frequently prescribed to patients with stage 1 or 2 follicular lymphoma. Radiation alone could treat this kind of cancer in certain circumstances. If the cancer is advanced, it may require radiation and other treatments.
2. Monoclonal Antibodies: Monoclonal antibodies are drugs that attack specific tumor markers and assist the immune cells in fighting cancer. Rituximab (Rituxan) is a monoclonal antibody used to treat follicular lymphoma. It is usually administered as an intravenous (IV) infusion, and it is also frequently used in conjunction with chemotherapy to treat delayed follicular lymphoma.
3. Chemotherapy: Chemotherapy is the use of chemicals to destroy cancer cells in the body. It is occasionally used to treat follicular lymphoma patients and is commonly coupled with other therapies, such as monoclonal antibodies or radiation therapy.
4. Radioimmunotherapy: Radioimmunotherapy is a cancer-killing treatment that combines monoclonal antibodies and radiation therapy. Ibritumomab tiuxetan (Zevalin) is a monoclonal antibody used to treat relapsed or refractory follicular lymphoma. Refractory cancer indicates that it does not react or cease responding to therapy.
5. Transplantation of Stem Cells: A stem cell transplant occasionally treats follicular lymphoma, mainly if the disease reappears. In this surgery, healthy stem cells are infused into the body to replace damaged bone marrow. Unfortunately, it is often only available to persons in good overall health. Stem cell transplants are classified into two types:
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Autologous Transplantation- This treatment treats cancer by using the patient's stem cells.
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Transplantation From a Donor- A donor's healthy stem cells are used in this treatment. Unfortunately, it is seldom used to treat follicular lymphoma.
As treatment choices improve, the survival percentage is anticipated to grow more.
Conclusion
Refractory follicular lymphoma refers to cancer that has not responded to initial therapy. Refractory illness is defined as a disease that grows worse or stays the same. Relapsed follicular lymphoma is cancer that has responded to treatment but has recurred. Follicular lymphoma is a slow-growing malignancy that begins in the lymph nodes. Many patients with follicular lymphoma can survive an extended period.
Follicular lymphoma develops slowly. Thus, immediately starting the treatment protocol can help avoid it. Many patients with this cancer survive for a long time and have a good quality of life. The exact cause of why follicular lymphoma occurs is unknown. A mix of genetic, environmental, and immunologic variables is most likely responsible.
