Part 4: Indolent B-Cell Non-Hodgkin Lymphoma

Robert Frank Cornell, MD

Hematology/Oncology Fellow, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Timothy S. Fenske, MD

Associate Professor of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Question 3

Questions 35 are based on the following clinical scenario:
A 62-year-old man presents with fatigue, weight loss, and night sweats. Physical exam reveals enlargement of the cervical and inguinal lymph nodes bilaterally. There is no hepatosplenomegaly. Imaging by CT confirms the physical exam findings with no additional sites of disease. Peripheral blood counts are within normal limits. An excisional lymph node biopsy is performed and shows a grade II follicular lymphoma. Lactate dehydrogenase and 2-microglobulin are moderately elevated. The only comorbidity present is exercise-induced asthma.

What would be appropriate treatment at this time?

  •  Watch and wait
  •  Single-agent rituximab
  •  ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy
  •  Rituximab plus bendamustine

Updated 02/15/2012 • jdw | Copyright ©2014 Turner White Communications