Relapsed non-Hodgkin's lymphoma: detection and treatment.
OBJECTIVE
To evaluate the optimal management strategy during clinical remission and after relapse in patients with non-Hodgkin's lymphoma (NHL).


METHODS
Sixty-six patients with relapse of NHL from a state of clinical remission between 1987 and 1997 were analyzed retrospectively. The pattern of relapses, diagnostic methods used for relapses, and clinical outcome of salvage treatment were analyzed with attention to time after the achievement of clinical remission.


RESULTS
Thirty-three relapses (50%) occurred within 12 months, and the remainder occurred gradually from 12-48 months after the first remission. Diagnosis of relapse in 61 of the 66 patients (93%) was made at unscheduled evaluations prompted by symptoms, on physical examinations, or because of high LDH levels. The 1- and 5-year cause-specific survival rates after relapse were 56.7% and 39.4%, respectively. The 1- and 5-year relapse-free survival rates were 50.1% and 35.0%, respectively. The 5-year relapse-free survival rate in patients with late relapse (49.5%) was significantly better than in those with early relapse (21.2%) (p<0.01).


CONCLUSIONS
Time to relapse may be a useful factor to determine optimal management strategy in NHL patients.
Shioyama
Y
Y
Department of Radiation Oncology, Institute of Clinical Medicine, University of Tsukuba, Japan.
Nakamura
K
K
Kunitake
N
N
Kimura
M
M
Terashima
H
H
Masuda
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome