Risks and outcomes of relapse in patients with diffuse large B-cell lymphoma

This study examined the difference between early and late relapses in patients with diffuse large B-cell lymphoma. The authors concluded that patients who experience a late relapse have better outcomes than those who experience early relapse.

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma. It is the most commonly diagnosed type of NHL. Approximately 66% of cases of DLBCL are curable. However, roughly 30% to 40% of patients who are in remission will relapse.

Most relapses occur early, within 1 or 2 years of remission. Some patients relapse late, after many years of being in remission. More research is needed on the definition and differences between early relapse (ER) and late relapse (LR).

This study looked at the differences in outcome between patients who experienced early relapse and those who experienced late relapse. The medical records of 7247 patients with DLBCL were reviewed. Of those patients, 556 patients experienced an early relapse and 78 experienced a late relapse. The average follow-up time was 6.8 years.

Late relapse occurred an average of 7.2 years after initial remission. The 5-year overall survival rate (time from relapse to death from any cause) for early relapse patents was 20%. The 5-year overall survival rate was significantly higher for late relapse patients (42%). 

Rituximab treatment significantly lowered the chance of either early or late relapse. Patients treated with rituximab had 83% lower odds of an early relapse, and 76% lower odds of a late relapse.

Radiation therapy was associated with a lower risk of early relapse compared to late relapse.

The study concluded that patients who experience a late relapse have better outcomes than patients who have an early relapse, and the use of rituximab was associated with a reduced risk of early or late relapse.

This was a retrospective study, meaning the data was gathered from patient records over a 30 year period. Treatment and care options have changed over this time.