GELF Criteria Calculator (Follicular Lymphoma)

GELF criteria for high tumor burden in follicular lymphoma (treatment indication).

For educational and clinical reference. Not a substitute for medical judgment. See the medical disclaimer.

Nodal or extranodal tumor mass > 7 cm

≥ 3 nodal sites, each > 3 cm

Presence of B symptoms

Symptomatic splenomegaly (spleen below the umbilicus)

Pleural effusion or peritoneal ascites

Cytopenias (ANC < 1.0 ×10⁹/L and/or platelets < 100 ×10⁹/L)

Leukemic phase (> 5.0 ×10⁹/L circulating malignant cells)

Score

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Interpretation

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References

Brice P, Bastion Y, Lepage E, et al. Comparison in low-tumor-burden follicular lymphomas between an initial no-treatment policy, prednimustine, or interferon alfa. J Clin Oncol. 1997;15(3):1110-1117.

How to use

Select each GELF criterion that is present.
Any single positive criterion classifies the patient as high tumor burden.
Use to inform the watchful-waiting vs initiate-treatment decision.

Frequently asked questions

What are the GELF criteria?

The Groupe d’Etude des Lymphomes Folliculaires criteria define “high tumor burden” in follicular lymphoma. Meeting any single criterion indicates high burden.

How are GELF criteria used?

They help decide whether to initiate therapy: low-burden, asymptomatic patients may be observed (watchful waiting), whereas high-burden disease usually warrants treatment.

Are GELF criteria a prognostic score?

No — they assess tumor burden / treatment indication. Prognosis in follicular lymphoma is assessed with the FLIPI or FLIPI-2 indices.

Does meeting a criterion mandate treatment?

It strongly supports it, but the final decision integrates patient preference, symptoms, comorbidity, and goals of care.

Last updated June 28, 2026