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In general, cytopenias can occur but constitutional symptoms of fever, nightsweats, and weight loss are uncommon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Diagnosis:<\/jats:title><jats:p>Diagnosis is based on histology of preferably biopsy of a lymph node. Immunohistochemical staining is positive in virtually all cases for cell surface CD19, CD20, CD10 and monoclonal immunoglobulin, as well as cytoplasmic expression of bcl\u20102 protein. The overwhelming majority of cases have the characteristic t(14;18) translocation involving the IgH\/bcl\u20102 genes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Risk stratification:<\/jats:title><jats:p>The Follicular Lymphoma International Prognostic Index prognostic model for FL uses five independent predictors of inferior survival: age &gt; 60 years, hemoglobin &lt;12 g\/dL, serum LDH &gt; normal, Ann Arbor stage III\/IV, number of involved nodal areas &gt; 4. The presence of 0\u20131, 2, and \u22653 adverse factors defines low, intermediate, and high\u2010risk disease with median 10 year survivals in the pre\u2010rituximab era of approximately 71, 51, and 36 months, respectively. With the use of more modern therapies, specifically anti\u2010CD20 monoclonal antibody, the outcome has improved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Risk\u2010adapted therapy:<\/jats:title><jats:p>Observation continues to be adequate for asymptomatic patients with low bulk disease and no cytopenias. For patients needing therapy, most patients are treated with chemotherapy plus rituximab, which has improved response rates, duration of response, and overall survival. Randomized studies have shown additional benefit for maintenance rituximab both following chemotherapy\u2010rituximab and single agent rituximab. Autologous stem cell transplantation has not shown a survival benefit in first remission patients. Stem cell transplantation (SCT) including both autologous and allogeneic SCT or experimental agent therapy is considered for recurrent disease. Am. J. 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