[Treatment of recurrent lymphoma]

Patients with recurrent lymphoma have a poor prognosis, even when a new remission can be obtained. In follicular lymphomas this remission is shorter. In aggressive lymphomas less than 10% of the patients survive for 5 years. Salvage treatments include drugs that were not administered in the induction of treatment. In follicular lymphomas new drugs which interfere with adenosine deaminase are very promising. In view of the bad results of rescue treatment and of the good sensitivity of lymphomas, even when recurrent, to radiotherapy and chemotherapy, intensive treatments combined with allogeneic or autologous graft of haematopoietic stem cells have been tested, and the results obtained seem to be better than those of conventional treatments. The position of these new treatments will be more clearly defined when the results of randomized studies are known. However, the prognosis of recurrent lymphoma can be further improved by reducing the toxicity of intensive treatments with the use of haematopoietic growth factors, by ridding the graft of malignant cells and by stimulating the post-graft immune defence to diminish the incidence of recurrences.