If your Follicular Lymphoma treatment is successful, you’ll be told that you have had a response and are in remission. Remission means that your body has responded positively to your treatment and your lymphoma is much smaller or gone completely. A complete response (CR) is when all the areas of the body affected by lymphoma are completely normalised by whatever measure is being used, usually a CT scan, though in some countries PET scans are used. If the enlarged areas affected by lymphoma overall have reduced in size by at least 50% but are still larger than normal, this is termed a partial response (PR).
The overall response rates (this includes both complete and partial response) to initial immunochemotherapy for FL are 80-90%. Around 50% of people with Follicular Lymphoma will have a first remission lasting 5-10 years after their initial treatment.
Although complete response (CR) means current tests can no longer detect any evidence of visible cancer, unfortunately we know that a low level of lymphoma cells can still remain and the likelihood is that it will return in the future. You will be monitored closely and this enables you to restart treatment when you need to.
If you are in remission, your doctor may suggest that you have something that’s referred to as ‘maintenance therapy’. This is where further treatments are provided for a period of time to help keep the cancer at bay for longer.
At the present time, maintenance therapy involves further Rituximab treatments – usually a dose every 2 months for 2 years. Rituximab maintenance therapy has been shown to keep lymphoma under control and postpone its reappearance, but not affect overall survival. The risks and benefits should be discussed with your doctor. Because rituximab can suppress your immune system, and in particular block response to vaccines including Covid vaccines, this may affect the decision on whether you should have maintenance or not.
Obinutuzumab can also be used for maintenance therapy in a similar way if you received it as part of your initial therapy.
If your doctor thinks that you would benefit from maintenance therapy, this will be discussed with you at your appointment.
