What is my current status? What does NCCN say I should do next

Based on your health summary, I'll break down your current status and provide NCCN-guided recommendations:

CURRENT STATUS FROM YOUR RECORDS:

• You have Stage 4 Follicular Lymphoma
• You've completed CAR-T cell therapy in 2024
• You currently have "low-level residual disease" post-CAR-T
• Your molecular testing shows several significant mutations (including DNMT3A, BCL2, TP53)
• Your tumor environment is characterized as an "immune desert" with high PD-L1 expression

According to current NCCN Guidelines for Follicular Lymphoma and the NCCN Guidelines for CAR-T Cell Therapy:

1. Post-CAR-T Monitoring:

• Regular monitoring with imaging and clinical assessments is recommended
• Molecular monitoring through liquid biopsies may be appropriate given your documented residual disease

1. Next Steps Options (per NCCN Guidelines):

• Clinical trial participation should be considered as a priority option, especially given your molecular profile
• Your records show 11 suitable trials identified, including epcoritamab-based studies at Dana Farber

The Leukemia & Lymphoma Society (LLS) guidelines also emphasize that patients with molecular findings like yours (particularly BCL2 mutations) may benefit from targeted therapies.

IMPORTANT RECOMMENDATION: Schedule a consultation with your healthcare team to discuss:

1. Interpretation of your post-CAR-T PET scan results (noted as needing immediate attention in your summary)
2. Clinical trial options, particularly the epcoritamab trials mentioned
3. Targeted therapy options based on your molecular profile

Sources:

1. NCCN Guidelines for B-Cell Lymphomas (Version 2023)
2. NCCN Guidelines for CAR T-Cell Therapy
3. Leukemia & Lymphoma Society Treatment Guidelines (2023)