About Relapsed FL

You've always known this could happen, and now it has. Your Follicular B-cell non-Hodgkin Lymphoma (FL) has returned, or relapsed. That means that your lymphoma cells are, once again, growing and crowding out the normal, healthy blood cells.

This time around though, your doctor has decided to try something different for your relapsed FL — an alternative treatment approach. With ZYDELIG. ZYDELIG is used when FL worsens after treatment with at least 2 prior medicines. ZYDELIG was approved based on response rates. Data are not yet available to show if ZYDELIG improves symptoms or survival.

How was I diagnosed?

It's not uncommon for a relapse diagnosis to take you by surprise. You may be feeling relatively well, with no or few symptoms, when you hear the news. Chances are your doctor confirmed your diagnosis through a combination of your medical history and one or more of the following tests:

  • a physical examination
  • blood and/or bone marrow tests
  • a biopsy of your lymph nodes
  • genetic analysis
  • computed tomography (CAT scan)

Staging my FL

Once your healthcare team has confirmed that you have relapsed FL, they will have to determine how advanced it is, in order to develop the best treatment plan for you. Having been through this before, you may already be familiar with the different FL stages and their symptoms.

Ann Arbor Staging System


  • FL is found in one lymph node group
  • FL is found in one area of a single organ outside the lymph system
  • FL is found in two or more lymph node groups on the same side of the diaphragm (a thin muscle under the lungs that separates chest and abdomen)
  • FL extends from a single group of lymph nodes into a nearby organ
  • FL is found in lymph node groups on both sides of the diaphragm
  • FL is found in an area or organ next to the lymph nodes, in the spleen or both
  • FL is found outside the lymph system in the organ or organs that is not right next to the affected lymph node


  • No fever, no excessive sweating, and no weight loss
  • Fever, excessive sweating, and weight loss
  • Presence of "bulky" disease described by large masses of lymphocytes
  • Means "extranodal organ" or outside the lymph system
  • Spleen is affected

Ways to Treat

Before beginning treatment for your relapsed FL, it's important that you understand the goals of therapy. They include:

  • reduction of the size of the lymph nodes
  • providing you with periods of remission

Having had FL before, you're probably familiar with more conventional treatments. These include chemotherapy, where one or more medications are used to destroy fast-growing cells (including your cancer cells), radiation therapy, where treatment with high energy rays, such as x-rays, are used to kill cancer cells or shrink tumors, and antibody therapy, which kills tumor cells directly or indirectly.

Ways to treat follicular lymphoma


General Do's and Don'ts of taking ZYDELIG as well as general dosing information and what to do if you miss a dose.

Learn More

Patient and Caregiver Resources

Staying informed about your disease and treatment can help you feel more confident in your fight.

See Patient Resources

Important Safety Information

What is the most important information I should know about ZYDELIG?

ZYDELIG can cause serious side effects that can lead to death, including:

  • Liver problems. Abnormal liver blood test results are common during treatment with ZYDELIG. ZYDELIG can cause severe liver problems. Your doctor will do blood tests before and during your treatment with ZYDELIG to check for liver problems. Tell your doctor right away if you get yellowing of your skin or the white part of your eyes (jaundice), dark or brown (tea-colored) urine, pain in the upper right side of your stomach area (abdomen), or bleeding or bruising more easily than normal.
  • Severe diarrhea. Diarrhea is common during treatment with ZYDELIG and can sometimes be severe. Tell your doctor right away if the number of bowel movements you have in a day increases by 6 or more. Ask your doctor about medicines you can take to treat your diarrhea.
  • Lung or breathing problems. Your doctor may do tests to check your lungs if you have breathing problems during treatment with ZYDELIG. Tell your doctor right away if you get new or worsening cough, shortness of breath, difficulty breathing, or wheezing.
  • Infections. Tell your doctor right away if you have a fever or any signs of an infection while taking ZYDELIG.
  • Tear in intestinal wall (perforation). Tell your doctor or get medical help right away if you get new or worsening stomach area (abdomen) pain, chills, fever, nausea, or vomiting.
  • Severe skin reactions. Tell your doctor right away if you get painful sores or ulcers on your skin, lips, or in your mouth; a severe rash with blisters or peeling skin, or a rash with itching.

If you have any of the above serious side effects during treatment with ZYDELIG, your doctor may completely stop your treatment, stop your treatment for a period of time, or change your dose of ZYDELIG.

Who should not take ZYDELIG?

  • Those with a history of serious allergic or skin reactions, as determined by a doctor.

What are the other possible side effects of ZYDELIG?

ZYDELIG can cause serious side effects, including:

  • Serious allergic reaction. Tell your doctor or get medical help right away
  • Low white blood cell count (neutropenia). Neutropenia is common during treatment with ZYDELIG and can sometimes be severe. Your doctor will check your blood counts regularly during treatment with ZYDELIG. Tell your doctor right away if you have a fever or any signs of an infection.

The most common side effects of ZYDELIG when used alone include feeling tired, nausea, cough, fever, stomach area (abdomen) pain, pneumonia and rash.

What should I tell my doctor before taking ZYDELIG?

  • All of your medical conditions, including if you have liver, lung, or breathing problems or an infection.
  • If you are pregnant or plan to become pregnant. ZYDELIG may harm your unborn baby. Women who are able to become pregnant should use effective birth control (contraception) during treatment with ZYDELIG and for at least 1 month after the last dose of ZYDELIG. Talk to your doctor about birth control methods. Tell your doctor right away if you become pregnant or think you are pregnant during treatment with ZYDELIG.
  • If you are breastfeeding or plan to breastfeed. You and your doctor should decide if you will take ZYDELIG or breastfeed. You should not do both.
  • All the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. ZYDELIG and certain other medicines may affect each other.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1‑800‑FDA‑1088. You can also call 1‑800‑GILEAD‑5 (1‑800‑445‑3235).

Please see full Prescribing Information, including Medication Guide with important warnings.

Gilead, the Gilead logo, ZYDELIG, the ZYDELIG logo, and AccessConnect are trademarks of Gilead Sciences, Inc., or one of its related companies. Other brands noted herein are the property of their respective owners. © 2017 Gilead Sciences, Inc. All rights reserved. ZYDC0182 (02/2017)