It’s a relief when your oncologist tells you that your follicular lymphoma is in remission. Whether you’ve just completed your first round of treatment or you’ve gone through one or more relapses, it’s good to know what to expect during remission and how long it will last so you’re more prepared for the future.

In this article, we’ll cover how long remission usually lasts in people with follicular lymphoma, what it means to relapse early or late, and factors that can affect how long remission lasts. We’ll also go over the signs of relapse and the importance of follow-up care.

Partial vs. Complete Remission in Follicular Lymphoma

When you go into remission from follicular lymphoma, it means the cancer has shrunk or even disappeared after treatment. Types of remission include:

• Partial remission — Some signs of cancer remain.
• Complete remission — No cancer cells are detectable.

For people with follicular lymphoma, remission doesn’t necessarily mean that the cancer is cured, but it can mean a break from treatment. Most people with follicular lymphoma will go through multiple cycles of remission and relapse (when cancer returns after a period of improvement).

How Long Does Remission Last?

The length of remission can vary from person to person. For many people, the first remission lasts several years. Studies show that about half of people with follicular lymphoma will have a first remission that lasts between five and 10 years. But some people can stay in remission for longer, depending on how well their blood cancer responds to treatment.

About half of people with follicular lymphoma will have a first remission that lasts between five and 10 years.

Are Later Remissions Shorter?

Unfortunately, after the first remission, the chances of relapse increase and the periods of remission often get shorter with each relapse. This means that someone’s first remission might last five years, but their second remission could be shorter — maybe two to three years. Over time, relapses can happen more often, and the lymphoma may become harder to treat.

Early vs. Late Relapse

It’s considered an early relapse when follicular lymphoma comes back within two years of the initial treatment. If the lymphoma returns this quickly, it may mean that the disease is more aggressive or harder to treat. People who experience an early relapse often need more aggressive treatment to manage the disease. Additionally, the prognosis (outlook) may not be as positive as it is for those who relapse later.

A late relapse occurs when the lymphoma comes back more than two years after the initial treatment. A late relapse usually means the disease is less aggressive, and people with late relapses tend to respond better to additional treatments. Overall, the outlook is more favorable for those who have a late relapse compared to an early one.

Factors That Affect the Length of Remission

Different factors can influence how long remission lasts with follicular lymphoma and whether someone will experience an early or late relapse. These can include the type of treatment, response to initial therapy, age, overall health, and the specific characteristics of the tumor.

Having an early relapse — within two years of the initial treatment — may mean the follicular lymphoma is more aggressive and harder to treat.

Type of Follicular Lymphoma Treatment

There are multiple treatment options available for follicular lymphoma, and the type of treatment a person receives can play a major role in how long remission lasts. People treated with a combination of chemotherapy and immunotherapy (like rituximab) often have longer remission periods than those treated with chemotherapy alone. The stage or grade of your follicular lymphoma can also play a role in what sort of treatment you receive and how likely you may be to experience remission after treatment is complete.

Response to Initial Therapy

If someone has a complete response to their first round of treatment, which means that no cancer cells are detectable, they’re more likely to stay in remission for longer than those who have a partial response, with some cancer remaining. A complete response is a good sign that the treatment worked well, and the lymphoma may stay away for a longer time.

Age and Overall Health

Young people and those in better overall health tend to have longer remissions. They may be able to handle more aggressive treatments, which can keep the lymphoma in check for a longer period. On the other hand, older individuals or those with other health problems might experience shorter remissions due to limited treatment options or their ability to tolerate side effects of therapy.

Tumor Biology

Specific details of the cancer cells can also affect how long remission lasts. Some people have genetic mutations on their cancer cells, such as TP53, which make their lymphoma more aggressive and more likely to relapse early.

Symptoms of an Follicular Lymphoma Relapse

If your follicular lymphoma comes back, your symptoms might be similar to those you experienced when the disease was first diagnosed. Some common symptoms of an follicular lymphoma relapse include:

• Swollen lymph nodes
• Night sweats
• Fever
• Unexplained weight loss
• Fatigue

If you notice any of these symptoms, talk to your health care team right away. Catching symptoms early is important for preventing the cancer from advancing to later stages and can make a big difference in long-term survival rates.

What Happens After a Relapse?

Most people with follicular lymphoma will experience at least one relapse. But there are many treatment options available to help manage the disease, even after it comes back.

Treatment Options After a Relapse

When follicular lymphoma relapses, doctors often recommend second-line treatments, which are different from the initial therapy. For example, if you received chemotherapy the first time, your doctor might recommend a different type of chemotherapy drug or a combination with rituximab (Rituxan) after your relapse in case you didn’t get it before.

There are many treatment options available for follicular lymphoma after a relapse.

Another option after a relapse is treatment with targeted therapy (drugs that target specific pathways in cancer growth). In some cases, your doctor might recommend immunotherapy treatment options. Your oncologist may recommend drugs like lenalidomide (Revlimid), obinutuzumab (Gazyva), epcoritamab (Epkinly), or tazemetostat (Tazverik) to help control the disease after relapses.

In some cases, a bone marrow transplant may be an option, especially for younger people. This treatment involves replacing damaged or cancerous blood cells with healthy ones. Your doctor will take healthy bone marrow cells — either from your own body or from a donor — and put them into your bloodstream, where they can develop into new, healthy blood cells.

Your doctor may also recommend joining a clinical trial to gain access to new treatment options that are still under development.

Importance of Follow-Ups

After treatment, it’s critical to attend all follow-up appointments with your health care team or oncologist. Regular check-ups allow your oncology team to monitor for any signs of relapse. This may be done through physical exams, blood tests, and imaging scans.

Even between scheduled appointments, it’s important to pay attention to how you’re feeling. If you notice any unusual symptoms, like swollen lymph nodes or night sweats, don’t wait until your next appointment — contact your doctor right away. Catching a relapse early can lead to better treatment outcomes.

Talk With Others Who Understand

On MyLymphomaTeam, the social network for people with lymphoma and their loved ones, more than 19,000 members come together to ask questions, give advice, and share stories with others who understand life with lymphoma.

How long have you been in remission from follicular lymphoma? How many relapses have you experienced? Share your experience in the comments below, or start a conversation by posting on your Activities page.