Patterns Of Relapse After Initial Treatment Of Hodgkins Lymphoma

Although late relapses occur, most relapses are seen within the first 5 years of treatment. Relapse risk and location are significantly affected by stage at presentation, prognostic factors, and therapy given. Long-term follow-up for patients with Hodgkin's disease reveals that approximately 70% of the disease-related deaths occur during the first 5 years and virtually no disease-related deaths are seen after 10 years. There are no data to suggest that early detection of recurrences can necessarily improve survival. However, clinical trials suggest that salvage treatment for HL is more effective when patients have minimal disease than when they have bulky disease at recurrence. However, no trial has demonstrated an advantage for treatment when disease is detected by routine screening studies versus symptomatic relapse.1'2

Figure 76.1 The actuarial risks of death from major disease categories. HD = Hodgkin's disease (From Ref. 1. Reprinted with permission from the American Society of Clinical Oncology)

Table 76.1 Suggested follow-

up schedule for patients with Hodgkin's


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