{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T17:41:21Z","timestamp":1769276481107,"version":"3.49.0"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,7]],"date-time":"2019-04-07T00:00:00Z","timestamp":1554595200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"JANSSEN-CILAG Australia"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Outcomes with follicular lymphoma (FL) have improved in the modern era and median survival is now beyond 15 years. Therapeutic decisions need to consider this increased survival as well as recent clinical trial data and emerging treatments. In this context, we present here current approaches to front\u2010line management of FL in Australia. Treatment choices depend on the disease stage, tumour burden, the patient's age, symptoms, comorbidities and preferences. Only about 10\u201315% of patients with FL are diagnosed with early stage disease. For patients with low\u2010grade, early stage disease, radiotherapy (RT) is recommended. The addition of chemotherapy has been shown to increase progression\u2010free survival (PFS) but without demonstrated overall survival advantage. For patients with low\u2010tumour\u2010burden, advanced\u2010stage FL, immediate treatment may not be required and we recommend considering active monitoring. For stage III\/IV disease that is symptomatic and\/or with high tumour burden, established first\u2010line treatment is chemotherapy in combination with rituximab, often followed by rituximab maintenance. The listing of bendamustine and now obinutuzumab on the Pharmaceutical Benefits Scheme has expanded the first\u2010line treatment options in Australia to include bendamustine in combination with rituximab (without rituximab maintenance permitted) or with obinutuzumab plus 2 years obintuzumab maintenance. In the FL subgroup of the Study group indolent Lymphomas (StiL) trial, therapy with bendamustine plus rituximab significantly increased PFS compared with rituximab in combination with cyclophosphamide, doxorubicin, vincristine and prednisolone, without rituximab maintenance. Initial tolerability may be more favourable with bendamustine in combination with anti\u2010CD20 antibody therapy than other therapies overall, but clinical vigilance is still required because of concerns of late infectious toxicities associated with prolonged T\u2010cell depletion.<\/jats:p>","DOI":"10.1111\/imj.14113","type":"journal-article","created":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T12:25:22Z","timestamp":1537359922000},"page":"422-433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Front\u2010line management of non\u2010Hodgkin lymphoma in Australia. Part 1: follicular lymphoma"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8009-4593","authenticated-orcid":false,"given":"Judith","family":"Trotman","sequence":"first","affiliation":[{"name":"Department of Haematology Concord Hospital  Sydney New South Wales Australia"},{"name":"Department of Medicine University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan Y.","family":"Cheah","sequence":"additional","affiliation":[{"name":"Department of Haematology Sir Charles Gairdner Hospital  Western Australia Australia"},{"name":"Department of Haematology Pathwest Laboratory Medicine  Western Australia Australia"},{"name":"School of Medicine University of Western Australia  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2512-917X","authenticated-orcid":false,"given":"Paula","family":"Marlton","sequence":"additional","affiliation":[{"name":"Division of Cancer Services, Clinical Haematology Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"University of Queensland School of Medicine  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Opat","sequence":"additional","affiliation":[{"name":"Clinical Haematology and School of Clinical Sciences Monash Health  Victoria Australia"},{"name":"Department of Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,7]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Cancer in Australia 2017","author":"Australian Institute of Health and Welfare","year":"2017"},{"key":"e_1_2_6_3_1","unstructured":"Leukaemia Foundation Australia.Follicular lymphoma.[cited 2018 Feb 12]. 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