Therapeutic Goals and Quality-of-Life Considerations in Transformed Disease

The experts next focus on clarifying the therapeutic goals for patients with transformed follicular lymphoma, particularly older adults. NP Bailey emphasizes that treatment goals must balance disease control, symptom reduction, hospitalization avoidance, and overall quality of life, while also recognizing that transformation introduces a potential opportunity for cure through aggressive modalities such as CAR T-cell therapy. Dr. Mehta and Bailey discuss how rapid disease progression may necessitate interim therapies to stabilize the patient until definitive treatment can be delivered. They revisit the diminishing role of autologous transplant in this population, noting that CAR T-cell therapy has largely supplanted transplant as the preferred curative-intent strategy. The segment also highlights the importance of individualized decision-making. Age alone should not exclude patients from cellular therapy, but comorbidities, functional reserve, and social support structures must be carefully assessed. The faculty stress the importance of realistic goal setting, clear communication, and aligning treatment intensity with patient priorities. This segment offers a nuanced discussion of how to approach transformed disease with both clinical rigor and patient-centered care principles.