American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the only curative therapy for follicular lymphoma?

1. Chemotherapy

2. Radiation therapy

3. Allogeneic hematopoietic stem cell transplantation

4. Monoclonal antibody therapy

The correct answer is: Allogeneic hematopoietic stem cell transplantation

Allogeneic hematopoietic stem cell transplantation is considered the only curative therapy for follicular lymphoma, especially in cases where the disease has transformed or in younger patients with relapsed and refractory disease. This procedure involves transferring stem cells from a donor to the recipient, allowing for the possibility of the immune system from the donor to recognize and eliminate residual lymphoma cells. In patients with follicular lymphoma, the standard treatments like chemotherapy, radiation therapy, and monoclonal antibody therapy are effective for managing the disease and prolonging remission, but they do not typically lead to a cure. The nature of follicular lymphoma, which is often indolent and can relapse after standard treatments, means that only stem cell transplantation has the potential for complete eradication of the disease and restoration of normal hematopoiesis. This approach can also harness the graft-versus-lymphoma effect, whereby the donor's immune cells target and destroy residual cancer cells. While all treatments have their places within the management of follicular lymphoma, the unique capacity of allogeneic stem cell transplantation to offer a definitive cure under the right circumstances sets it apart as the only curative option in this context.