LATE RELAPSE IN DLBCL

Br J Haematol. 2010 Sep 29. doi: 10.1111/j.1365-2141.2010.08330.x. [Epub ahead of print]
Late relapse in patients with diffuse large B-cell lymphoma.
Vose JM, Weisenburger DD, Loberiza FR, Arevalo A, Bast M, Armitage J, Bierman PJ, Bociek RG, Armitage JO.

Department of Internal Medicine, Section of Hematology/Oncology, University of Nebraska Medical Center Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA.
Abstract

The outcomes for 162 patients with diffuse large B-cell lymphoma treated with a CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone)-like regimen who obtained a complete remission and who subsequently relapsed after ≥5 years of remission (late relapse, N = 30), or <5 years of remission (early relapse, N = 132), were compared. The late relapsing patients had better prognostic characteristics at diagnosis, such as stage I/II disease (73% vs. 49%, P = 0·04), a normal lactic dehydrogenase (77% vs. 48%, P = 0·01), and a Karnofsky performance score of ≥80 (100% vs. 86%, P = 0·01). The 3-year survival after relapse was better in late relapsing patients (48% vs. 25%, P = 0·03), but the survival at 5 years (32% vs. 20%) and 10 years (13% vs. 14%) after relapse was not different. A multivariate analysis of factors predicting survival after relapse found age (P < 0·0001) and presence of B-symptoms (P = 0·03) to predict survival, but not early versus late relapse. A small percentage of the late relapsing patients can have a prolonged second remission. However, the overall survival from the time of relapse was not different between early and late relapsing patients with most succumbing to lymphoma.