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Detection of relapse in non‐Hodgkin's lymphoma: Role of routine follow‐up studies
Author(s) -
Elis Avishay,
Blickstein Dorit,
Klein Osnat,
EliavRonen Rivka,
Manor Yosef,
Lishner Michael
Publication year - 2002
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.10017
Subject(s) - medicine , lymphoma , complete remission , hematology , physical examination , hodgkin lymphoma , complete blood count , surgery , chemotherapy
Complete remission can be achieved in 60–80% of adults with diffuse aggressive non‐Hodgkin's lymphoma. However, 20–40% of them will subsequently relapse. Nevertheless, formal follow‐up guidelines for recurrence detection have never been advocated. We analyzed the pattern of relapse in 30 patients with intermediate‐ and high‐grade non‐Hodgkin's lymphoma and the value of intensive protocol for relapse detection. This protocol includes frequent follow‐up visits, complete blood count, and serum LDH tests along with annual chest, abdominal, and pelvic CT scans. The median duration of complete remission was 12 months. Twenty‐five relapses (83%) were suspected after an interim history and /or physical examination, whereas only 5 relapses (17%) were detected by routine radiographic or laboratory follow‐up studies. The majority of relapses (19/30) were detected in sites that included the sites of prior disease. For the first 12 months of complete remission, the estimated cumulative save in charge for a follow‐up strategy, based on regular visits in the hematology clinic and performing laboratory and radiologic studies as clinically indicated, is 44% of the cost of a routine intensive evaluation. A reliable and cost‐effective follow‐up method for non‐Hodgkin's lymphoma patients in complete remission should include frequent history and physical examination. Complementary studies should be performed according to clinical indications. Am. J. Hematol. 69:41–44, 2002. © 2002 Wiley‐Liss, Inc.