Non-Hodgkin's lymphoma: patterns of relapse from complete remission after combination chemotherapy

An analysis of patterns of relapse from complete remission in patients with non-Hodgkin's lymphoma treated with combination chemotherapy has demonstrated differences between histologic subgroups. Patients with diffuse histiocytic lymphoma who achieved a histologically proven complete remission after 6 months of treatment without maintenance have remained disease-free whereas those with nodular poorly differentiated lymphocytic and diffuse well-differentiated lymphocytic lymphomas have demonstrated a pattern of continuous late recurrence. The initial sites of relapse from complete remission in lymphocytic lymphoma were lymph nodes and bone marrow which were involved prior to treatment. Aggressive attempts at remission induction appear warranted in patients with diffuse histiocytic lymphoma because of the potential for extended disease-free survival. Patients with nodular poorly differentiated lymphocytic lymphoma may benefit from the use of maintenance chemotherapy, or radiotherapy to regions of previously known involvement after initiation of remission with chemotherapy.