Clinical outcomes associated with very late relapses in diffuse large cell lymphoma

While the majority of patients achieve complete remission (CR) following treatment for diffuse intermediate-grade and immunoblastic non-Hodgkin's lymphoma, many will eventually relapse. It is known that late-relapsing patients have a better prognosis than those who relapse earlier; however, the optimal choice of therapy and clinical outcomes in this former group remain uncertain. We report here our experience with patients who develop a very late relapse of their disease, defined as occurring in the fifth year or later from the time of original diagnosis following a period of continuous CR. The overall poor prognosis in this group of patients justifies the use of more aggressive treatment approaches in the future, such as high dose therapy with stem cell support, rather than conventional salvage chemotherapy regimens.