Abstract:Follicular lymphoma (FL) is a common subtype of B-cell malignancy, highly heterogeneous. While the majority of FL patients are clinically indolent at diagnosis, those who experience early progression or recurrence, multiple recurrences, or transformation into high-grade lymphoma are at a higher risk of mortality. However, prognostic models currently in widespread use are inadequate at accurately identifying the population; patients experiencing multiple recurrences are left without a remedy after exhaustion of existing treatment options. The development of tumor biology in FL has provided novel approaches for identifying strategies, establishing treatment foundations, and expanding treatment alternatives for patients with relapsed and refractory FL (R/R FL). This article provides an overview of the advancements in tumor biology related to FL and explores the identification and treatment options for R/R FL