Relapse of Hodgkin's disease after ten years

We report four cases of Hodgkin's disease (HD) relapsing after complete remission for over a 10-year period after the initial therapy. Three of the patients had mixed-cellularity subtypes as a primary histological diagnosis, and the rebiopsies demonstrated mixed cellularity in all very late relapse cases. Two patients were initially treated with radiotherapy, while in the other two advanced cases polychemotherapy was administered. All patients had advanced disease at the time of the very late relapses, though the relapse was not identifiable in the previously involved regions. By rescue therapy, all patients achieved a second complete remission. However, two patients relapsed again with one of them dying during relapse. The three remaining patients are still in complete remission. Our report demonstrates the necessity of prolonged follow-up of patients with HD.