Is bendamustine plus rituximab a suitable option for rituximab-refractory duodenal-type follicular lymphoma?

Duodenal follicular lymphoma (DFL) is a specific variant of FL, predominantly localized in the second portion of the duodenum and often represents an incidental finding, even if some cases can present with abdominal pain. Overall prognosis is excellent, with high progression-free survival (PFS) and overall survival (OS) (1). Watch&wait, rituximab or radiotherapy (RT) should represent a suitable first-line therapy with long-term efficacy (1-4). However, a small proportion of rituximab- refractory patients exists. Here we would like to report a rituximab-refractory DFL successfully treated with rituximab and bendamustine (BR).