Because the results will not change his treatment approach, Dr Williams does not test these patients unless they are experiencing recurrent infections. Dr Kahl on the other hand evaluates patients annually, noting that symptomatology such as infections take an extended time to develop. He also points out that many patients with lymphoma have low baseline immunoglobulin levels but do not develop recurrent infections, and therefore he only takes action if a low level is accompanied by repeated infections.

Hiddemann W, Cheson BD. How we manage follicular lymphoma. Leukemia 2014;28(7):1388-95. Abstract

Witzens-Harig M et al. Maintenance with rituximab is safe and not associated with severe or uncommon infections in patients with follicular lymphoma: Results from the phase IIIb MAXIMA study. Ann Hematol 2014;93(10):1717-24. Abstract