Indolent lymphoma at ASH (American Society of Hematology) 2017: maintenance revisited

At the last ASH (American Society of Hematology) meeting a new prognostic tool for follicular lymphoma (FL), based on the patient cohort of the PRIMA trial (PRIMA-PI, Primary Rituximab and Maintenance-Prognostic Index), was presented. The 10-year update of the PRIMA trial confirms the continuous advantage in progression-free survival of rituximab maintenance after R‑CHOP induction without new safety signals. Similarly rituximab maintenance is beneficial in FL after first-line chemoimmunotherapy with rituximab–bendamustine. Currently checkpoint inhibitors are under investigation in different treatment lines of FL. The earlier ibrutinib is administered in relapsed mantle cell lymphoma, the more effective the long-term efficacy is. New, more selective inhibitors of the Bruton’s tyrosine kinase (BTK) may be an option for patients in whom ibrutinib may be contraindicated.