Submitted October 25, 2006
Accepted February 5, 2007
How I treat indolent lymphoma
John G. Gribben*
Institute of Cancer, Barts and The London Queen Mary School of Medicine, London, United Kingdom
* Corresponding author; email: john.gribben{at}cancer.org.uk.
Despite advances in treatment, there was little evidence until recently that this had led to improvement in the survival of patients with indolent lymphoma, with patients continuing to have an unremitting course of relapse of disease. There appears to have been a change in the natural history of these diseases with the introduction of chemo-immunotherapy which may finally have resulted in improvements in survival. With so many agents available for the treatment of indolent lymphomas questions that have to be addressed include: is there still a role for a "watch and wait" approach in asymptomatic patients or should they be treated at diagnosis, what are the optimal first line and salvage treatments, what is the role of maintenance therapy and is there any role for stem cell transplantation in these diseases? No established treatment of choice has yet emerged and many of these questions remain unresolved. It is highly likely that our treatment approaches will continue to evolve as the results of ongoing clinical trials are released and that improvement in outcome will result from identification of therapies that target the underlying pathophysiology of the diseases.
