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Table 3. Sites of relapse, group A
Site of relapse
Total
Local/locoregional
Distant
Local + distant
Sweetenham et al.
n(%)
57 (100)
36 (63)
15 (27)
6(10)
patients receiving mediastinal irradiation, four have relapsed, three with
mediastinal involvement and one at distant sites only.
Of the 50 patients who received therapy after relapse, none achieved complete
remission. Responses were observed in 27 patients. Three patients, all of whom had
local or locoregional relapses, are alive >1 year after relapse. All have active disease.
Figure 2A shows the overall survival for all patients from the date of relapse after
transplant. The median overall survival for all 57 patients is 3 months. As shown in
Fig. 2B, no difference in survival was observed according to the pattern of relapse.
Group B
Of the 1339 patients for whom relapse data were available, 259 (19%) relapsed
in local or locoregional sites only. The remaining 1080 patients relapsed with
disease at distant sites, with or without involvement of previously affected sites.
Analysis of the frequency of local vs. distant relapse according to histologic
subtype, number of sites of involvement before high-dose therapy, status at
autoSCT, and source of hematopoietic rescue is shown in Table 4.
Overall, only 19% of patients relapsed entirely at previously involved sites. The
probability of local relapse was significantly lower in patients with lymphoblastic
or Burkitt's/Burkitt-like histology compared with the remaining patients
(P=0.016). The probability of localized relapse was inversely correlated with the
number of disease sites involved before autoSCT (f