Follicular Lymphoma: Treating Early Progressors

Case: A 62-Year-Old Male with Follicular Lymphoma

H & P:

• A 62-year-old man presents with lower abdominal discomfort and rapid weight loss over last 3 months
• PMH: Hypertension managed by statin
• PE: palpable inguinal lymphadenopathy

Diagnostic Work-Up

• Hematologic results
  • ANC: 1200 /µL
  • Platelets: 89,000 /µL
  • β₂-microglobulin: 3.5 mg/L
  • Serum LDH: 230 IU/L
• Imaging: PET/CT reveals axillary and bilateral inguinal lymphadenopathy; 5 masses (~3cm each)
• Biopsy: FL, grade 2
• FLIPI status: High-risk
• Ann Arbor: Stage IV
• ECOG PS: 1

Treatment

• Patient treated with obinutuzumab + bendamustine
  • Completed 6 cycles, achieved CR