Treatment will depend on the location, extent of recurrent or residual disease, previous management and the patient’s preferences.

In managing people with a low-grade lymphoma, treatment may include these options:

• The choice of systemic salvage treatment generally depends on the efficacy of previous regimens and the duration since the end of the prior If fewer than 24 months have elapsed since the prior treatment, a treatment regimen containing different, non-cross-resistant agents is optimal
• With additional immunosuppressive effects of therapy, the risk of opportunistic infection Prophylaxis is important with antimicrobials and/or immunoglobulin replacement as appropriate. Similarly, consider G-CSF as a primary or secondary prophylaxis for periods of neutropenia.

Follicular and marginal zone lymphomas (ESMO 2020)

• Asymptomatic patients may be observed (watch and wait).
• Radiation therapy may be considered for those with localised relapse, to defer systemic immuno-chemotherapy.
• Low-dose radiation therapy should be considered to palliate symptomatic sites of
• If systemic treatment is required, refer to Australian, British and European
• Consolidation of chemoimmunotherapy with autologous transplantation may be considered in fit patients.
• With many promising novel therapies, such as BTK inhibitors, and bi-specific antibody and CAR T-cell therapies, screening of patients for clinical trials are strongly

Mantle cell lymphoma

• At relapse, a BTK inhibitor should be considered as a priority
• Enrolment in a clinical trial is strongly
• In younger patients with adequate performance status and comorbidities, consider reduced- intensity allogeneic haematopoietic stem cell