Limited Benefit of Routine Clinical Follow-Up for Relapse Detection in Diffuse Large B-Cell Lymphoma Patients in...

Area of Science:

• Hematology
• Oncology
• Clinical Research

Background:

• Diffuse large B-cell lymphoma (DLBCL) is a common non-Hodgkin lymphoma.
• Approximately 15% of DLBCL patients relapse after achieving complete remission (CR) with first-line therapy.
• Optimal follow-up strategies for detecting DLBCL relapse after CR are not standardized.

Purpose of the Study:

• To evaluate the effectiveness of current follow-up strategies in detecting relapse in DLBCL patients.
• To analyze the proportion of relapses identified during scheduled versus unscheduled visits.
• To inform future strategies for DLBCL relapse surveillance.

Main Methods:

• Population-based study using the Danish Lymphoma Registry (LYFO).
• Included 1634 DLBCL patients diagnosed between 2010-2017.
• Focused on 105 patients who achieved CR after first-line R-CHOP-like therapy and subsequently relapsed; median follow-up of 6 years.

Main Results:

• Most relapses were symptomatic (83%), with B symptoms and lymphadenopathy being common.
• Asymptomatic relapses were detected via physical exam (1%), blood tests (3%), or imaging (13%).
• 70% of relapses were identified outside routine visits; 74% of unscheduled patient-initiated visits led to relapse detection, compared to 5% of scheduled visits.

Conclusions:

• Systematic, scheduled monitoring contributes modestly to early DLBCL relapse detection.
• Unscheduled, patient-initiated visits are more effective in identifying disease recurrence.
• Future research should explore alternative relapse surveillance methods beyond traditional follow-up schedules.