Inclusion Criteria:

- Histologically confirmed diagnosis of follicular lymphoma: grades I, II, or IIIA, or
non-follicular lymphoma: lymphoplasmacytoid lymphoma, small lymphocytic lymphoma,
marginal B-cell lymphoma, or MALT lymphoma (as defined in the WHO classification2) as
reviewed by a hematopathologist at Memorial Hospital.

- Staging fulfills criteria for no initial treatment according to GELF criteria for
advanced stage disease. None of the following should be present: 1) a nodal or
extranodal mass with a diameter of >7 cm, 2) involvement of at least three nodal
sites [each with a diameter of >3 cm], 3) systemic symptoms, 4) plenomegaly, or 5)
ureteral compression.

- No prior treatment for lymphoma is permitted.

- Karnofsky performance status > 70%

- The patient may not have a previous history of radiation therapy.

- Patient or guardian must be able to sign voluntary written consent.

- Male or female patients 18 years of age or greater.

Exclusion Criteria:

- Histologic diagnosis of intermediate grade or high grade non-Hodgkin's lymphoma.

- Histologic evidence of low grade transformation.

- Prior treatment for non-Hodgkin's lymphoma.

- Regional lymphoma (peripheral stages I and II) eligible for involved field
irradiation.

- GELF criteria35 for institution of systemic chemotherapy, which includes: 1) a nodal
or extranodal mass with a diameter of >7 cm, 2) involvement of at least three nodal
sites [each with a diameter of >3 cm], 3) systemic symptoms, 4) splenomegaly, or 5)
ureteral compression.

- Prior history of malignancy within the past five years or a concurrent malignancy,
with the exceptions of cutaneous basal cell carcinoma or carcinoma in situ of the
uterine cervix.

- Karnofsky Performance Status <70%.

- Patients with a known history of HIV seropositivity.

- Patients who require therapy with systemic corticosteroids.

- Patient or responsible guardian is unable to provide written informed consent.

- Pregnant or lactating women.