A more favourable clinical course of lymphoma relapsing after high-dose therapy: evidence of tumour heterogeneity?
Patients with Hodgkin's disease (HD) or large cell lymphomas who relapse after conventional chemotherapy have a poor prognosis without high-dose chemotherapy and stem cell transplantation (HDCT). Patients who relapse after HDCT have an extremely poor outcome. In the present study we describe four patients with relapsed HD (n=1) and large cell lymphomas (n=3) after HDCT. All had an aggressive clinical course before HDT. At relapse, however, they all have had prolonged remissions and/or spontaneous regressions on mild or no treatment. Possible explanations could be selection of less malignant clones or a lymphoma controlled by the immune system. The mechanisms are, however, unknown but warrant further studies of the molecular biology in these and similar cases.
Enblad
G
G
Departments of Oncology, Radiology and Clinical Immunology, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden. Gunilla.Enblad@onkologi.uu,se
Carlson
K
K
Bengtsson
M
M
Hagberg
H
H
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012075:Remission, Spontaneous; D016896:Treatment Outcome