Follicular lymphoma. A series of 11 patients with minimal or no treatment and long survival.

Follicular lymphoma is the commonest low-grade lymphoma. Its indolent nature even in advanced stages and the failure of conservative or aggressive treatments to achieve a cure have questioned the need for immediate treatment. Eleven patients with follicular lymphoma who had minimal or no treatment were retrospectively reviewed. Median age was 44 years. Staging was: I (4), III (6) and IV (1). Eight were confirmed to have follicular lymphoma of whom six did not receive treatment at presentation. Four of these patients remain in remission after 14 to 30 years of follow-up and the other two have relapsed after 10 and 13 years of follow-up, respectively. Two patients who were treated at diagnosis remained disease free for 18 years. Three patients had diffuse large cell lymphoma on review. They received no treatment, radiotherapy or chemotherapy and have been in remission for 36, 14 and 23 years respectively. The overall survival is 58% at 30 years, and median survival has not been reached for the whole group. Observation seems to be a valid alternative to treatment in patients with stages I to III until signs of progression.