Follicular Lymphoma (FL)

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Follicular Lymphoma (FL)?

Follicular Lymphoma (FL) is an indolent B-cell non-Hodgkin lymphoma from germinal center B-cells, the second most common NHL (20-25%). It’s graded 1-3, with grade 3 more aggressive. In 2025, ~20,000 US cases, median age 65, often advanced at diagnosis but slow-growing.

Symptoms

Symptoms include painless swollen lymph nodes (neck, groin, abdomen), B symptoms (fever, night sweats, weight loss in 10%), fatigue, abdominal fullness (splenomegaly). Many are asymptomatic. In 2025, incidental diagnosis is common.

Causes

Causes include t(14;18) translocation (BCL2 overexpression in 85%), with risk factors like age, family history, immunosuppression, and pesticides. In 2025, biology studies focus on microenvironment.

Diagnosis

Diagnosis uses biopsy with immunohistochemistry (CD20+, BCL2+), FISH for t(14;18), and PET-CT for staging (Lugano). Bone marrow biopsy assesses involvement. In 2025, NGS classifies subtypes.

Treatment

Watchful waiting for asymptomatic low-grade. Symptomatic uses rituximab, R-CHOP, or bendamustine-rituximab. Relapsed uses CAR-T (axicabtagene ciloleucel), bispecifics (mosunetuzumab). In 2025, epcoritamab shows 63% response.

Future Outlook

In 2025, 5-year survival is 90%, with indolent course. Bispecifics and CAR-T improve relapsed survival to 70%. By 2030, precision therapies could make FL curable.

Sources

The information for FL is sourced from NORD’s “Follicular Lymphoma – Symptoms, Causes, Treatment” for causes; Cleveland Clinic’s “Follicular Lymphoma: Stages, Symptoms, Treatment & Prognosis” for prognosis; PMC’s “Follicular Lymphoma: Current Therapeutic Landscape and Future Directions” for 2025 updates; Lymphoma.org’s “Follicular Lymphoma” for treatment; VJHemOnc’s “Key updates and takeaways in follicular lymphoma from ICML 2025” for biology; Medscape’s “Follicular Lymphoma Management Overview” for management; YouTube’s “Key updates and takeaways in follicular lymphoma from ICML 2025” for takeaways; NCBI’s “Follicular Lymphoma – StatPearls” for symptoms; Nature’s “Incidental vs. symptomatic diagnosis of follicular lymphoma” for diagnosis; The Minor Surgery Center’s “Lymphoma Explained (2025 Comprehensive Update)” for updates.