Onkológia 2/2014

Treatment of indolent B-cell lymphomas

Indolent B-cell lymphomas comprise a heterogeneous group of diseases. For patients with limited disease is local radioterapy the treatment of choice.Watch and wait is the standard of care for patients with asymptomatic advanced stage disease. Standard first line treatment for symptomatic pacients is chemoimmunotherapy. The recent rediscovery of the „old“ chemotherapeutic agent bendamustin enhanced therapeutic options in indolent B-cell lymphomas. Thanks its favourable therapeutic index and effectiveness it is increasingly used in the in the first line and relapse setting as well. In patients with follicular lymphoma, the maintenance with rituximab after effective chemoimmunotherapy is indicated. Earlier or later the relapse occurs in indolent lymphomas. It is the reason to have a wide variety of treatment options. In the last years we witness marked progress in the new drugs development. The new promising drugs are novel monoclonal antibodies, proteasome inhibitors, novel agents targeting a certain level of B-cell receptor signaling pathways, bcl-2 inhibitors or immunomodulatory agents. Novel agents may change our treatment approach to indolent lymphomas in the near future.

Keywords: indolent lymphomas, therapy, rituximab, bendamustin.