‘Indolent’ mature B-cell lymphomas

Indolent B-cell lymphomas, as the name suggests, describes a group of B-cell neoplasms that usually have a sluggish clinical course, particularly in elderly patients and have historically been controlled by relatively modest chemotherapy. They do, however, make up a very large cohort of lymphoma patients and tend to have a relentless course, eventually becoming more aggressive in nature and resistant to treatment, leading to the death of the patient. The incidence in the Western world is also increasing and the age of presentation is becoming younger. With the advent of increased biological understanding of their pathogenesis it has been possible to define many subgroups within this broad heading. This is leading to major improvements in treatment and survival with new biological therapies based on oncogenic pathways. Indolent lymphomas may present in a number of ways to different specialties in medicine and as such are important to recognize and understand. Recent advances have made this a rapidly advancing field with considerable improvements in outcome.