BRIEF Bendamustine and Rituximab In Elderly Follicular

Inclusion Criteria: * Histologically confirmed follicular lymphoma CD20+, all grades except the grade 3b with a lymph node biopsy performed within 6 months before study entry and with material available for central review * A minimal initial immunology is required, including : CD20, bcl-2, CD10 and CD5 * Age must be ≥ 60 years * Patients not previously treated * Patients with an intermediate or high risk FLIPI score requiring 2 or more of the following adverse prognostic factors: 1. Age \>60 ans 2. Ann Arbor Stage (III-IV vs. I-II) 3. Hemoglobin level ( \< 12g/dL vs. ≥ 12 g/dL) 4. Number of nodal areas (\< 5 vs. ≥ 5) (Note: LDH should not be considered as an adverse prognostic factor in this study since it is considered as high tumor burden in the GELF criteria) * Low burden disease at study entry according to the GELF criteria * Patients with at least one measurable site of disease: patients with only blood or marrow or splenic infiltration are excluded * Performance status ≤ 2 on the ECOG scale * Adequate hematological function (unless abnormalities are related to lymphoma infiltration of the bone marrow) including: * Hemoglobin ≥ 8.0 g/dL (5.0 mmol/L) * Absolute neutrophil count (ANC) ≥ 1.5 x 109/L * Platelet count ≥ 100 x 109/L * Adequate renal function: calculated creatinine clearance \> 50 ml/min (according to MDRD method) unless these abnormalities are related to lymphoma * Adequate hepatic function: Total bilirubin \< 2.0 mg/dl (34 µmol/L), AST (SGOT) and ALT (SGPT) ≤ 2.5 x the upper limit of normal unless these abnormalities are related to lymphoma * Adequate cardiac function: LEVF ≥ 50% calculated by echocardiography or scintigraphy * Having previously signed a written informed consent Exclusion Criteria: * Other histological types of lymphoma than follicular lymphoma * Grade 3b follicular lymphoma * Patients previously on watch and wait since more than 6 months from diagnosis * Patients previously treated for lymphoma, except splenectomy * Patients with low FLIPI score (0 or 1 adverse prognostic factors not considering elevated LDH) * Bulky disease at study entry according to the GELF criteria * Presence or history of CNS disease (either CNS lymphoma or lymphomatous meningitis) * Patients with prior or concomitant malignancies except non-melanoma skin cancer or adequately treated in situ cervical cancer or previous cancer in CR without any treatment in the last 5 years * Positive HIV, HBV (anti-HBc positivity) and HCV serologies before inclusion * Poor Performance status \> 2 on the ECOG scale * Known contra-indication to study product * Serious underlying medical conditions, which could impair the ability of the patient to participate in the trial (e.g. ongoing infection, uncontrolled diabetes mellitus, gastric ulcers, active autoimmune disease). * Any other co-existing medical or psychological condition that will preclude participation in the study or compromise ability to give informed consent.