A recent study highlights the limited effectiveness of routine follow-up in detecting relapses in patients with diffuse large B-cell lymphoma (DLBCL) who have achieved complete remission (CR) following first-line treatment. Despite advances in therapy, approximately 15% of these patients experience relapse, and finding the most effective surveillance strategy remains a challenge.
The study, based on data from the Danish Lymphoma Registry (LYFO), included 1,634 patients diagnosed with DLBCL between 2010 and 2017. Of these, 105 patients achieved CR following R-CHOP-like treatment but later relapsed. With a median follow-up period of six years, the study found that most relapses (83%) were symptomatic, typically presenting with B symptoms or peripheral lymphadenopathy. In contrast, only 30% of relapses were identified during scheduled follow-up visits.
Interestingly, 70% of relapses were detected outside of routine visits, primarily through unscheduled patient-initiated visits. Only 5% of relapses were identified during scheduled routine check-ups, indicating that current follow-up strategies are insufficient for early relapse detection. The study suggests that a more dynamic and responsive approach to relapse surveillance might be needed, focusing on patient symptoms and concerns rather than solely relying on pre-scheduled clinical visits.
These findings underscore the importance of exploring alternative relapse detection methods. Future research should consider how to improve surveillance and early detection for patients in remission, which could ultimately lead to better outcomes for DLBCL patients and enhance the effectiveness of relapse interventions.
Helena Bradbury, EMJ
Reference
Lassen T et al. Limited benefit of routine clinical follow-up for relapse detection in diffuse large b-cell lymphoma patients in complete remission following first-line treatment. 2025;doi: 10.1002/ajh.27577.
