BR versus RCHOP for Follicular Lymphoma


I am new here, posting for my 45 year old husband who was just diagnosed with Follicular Lymphoma, Stage 4, Grade 3a (30%) Grade 1-2 (70%) after a surgical biopsy on a lymph node in his neck. We are in the process of getting several opinions for treatment and struggling since there is not aggreement. Most of the doctors want to do RCHOP, but the oncologist at Stanford who only sees Lymphoma and seems to be an expert advises a less aggresive appraoch of BR. She also thought he would be a good candiate for a clinical trial which would give him either BR or BVR. She says he needs treatment since it is making his voice raspy from the enlarged nodes and because he has a large area of enlarged nodes in his neck, otherwise she would have done watch and wait. Because he has no symptoms besides the voice, she feels that the lesser treatment would be better. We like the idea of the less toxic treatment and saving RCHOP for recurrance, but it also makes us nervous since we know RCHOP is tried and true. He seems to be in a grey area since he has both Grade 1-2 and Grade 3a. We are hoping to get into UCSF this next week to get another opinion and hopefully clarify things. Any info and advice would be greatly appreciated!



  • Go Slow

    i had FNHL stage IV-3a diagnosis with bone marrow infiltration. Since earlier treatment seems to have no effect on overall survival and because with current treatment options FNHL almost always comes back, i chose the go slow approach and opted for Rituxan monotherapy. I had 26 infusions over 2 1/2 years and have been good since early 2012. I have my 1 year checkup after stopping Rituxan on April 8. This is a viable option if 1). No major organs are threatened and tumors have low bulk and 2). If you can accept that the disease is incurable and set a goal to manage it, not cure it. Condition #2 is a big psychological hurdle for most of us. I know I will eventually need chemo but have set a goal to delay it as long as possible and live life to the fullest.

    hope this helps. Remember I am not an oncologist and this is the road I selected for my situation. It may or may not be right for you guys.

  • Rocquie
    Rocquie Member Posts: 862 Member

    Lisa, welcome to the group. We have quite a few members with follicular lymphoma, myself included. I think almost every one of us has had different experiences and treatments. 

    I was treated with R-CHOP and an additional 2 years of Rituxan maintenance, which I finished about a month ago. I was diagnosed with transformed follicular lymphoma, stage 3B, grade 3A, and was considered a high-risk patient. My lymphoma was behaving like a more aggressive lymphoma; I was very symptomatic and therefore was treated with an aggressive first-line treatment. 

    I am glad you are checking out all the options to treat your husband. My Oncologist took my case before our state tumor board for opinions. He also referred me to Duke University for a second opinion, which included a second biopsy opinion, which I highly recommend, as my original diagnosis was changed. 

    You are doing for your husband, what my husband did for me: searching out information. I was too sick and too freaked out to do it for myself. Please know that there are many, many new advancements in treating this disease. Watch dates on websites you visit--many are outdated. I have learned the most (more than I ever wanted to know about lymphoma) from my fellow patients, here at this site. 

    Bless you both as you move forward in making these decisions. And please remember, lymphoma is very treatable. Your husband has a good long life ahead of him. 




  • givingrace
    givingrace Member Posts: 161
    Hi Lisa,
    I agree with what

    Hi Lisa,

    I agree with what everyone else has said. 

    I'm sorry you have had to join our group but welcome.

    My road with follicular has been text book I think. I ended up going  at it slow.  I was offered other options and I feel I did the right decision. I had a relapse and it is now gone again but I will go for some more rituxen maintenance.  

     Just be informed, stay strong and know we will be here if you ever want to vent,or have questions.