Salvage treatment after failure or relapse following initial chemotherapy for follicular non-Hodgkin's lymphoma

In an attempt to further define prognostic factors in patients with follicular non-Hodgkin's lymphoma, two subgroups of patients receiving 2nd line therapy; (a) those who had failed to achieve CR with initial therapy and (b) those who had relapsed after achieving initial CR, were examined. Patients who failed to achieve initial remission were not totally refractory to retreatment. Seven of 34 (21%) who had failed to respond to initial treatment achieved CR following treatment with various 'salvage chemotherapy' approaches. There were, however, no significant pretreatment prognostic factors that were predictive for response. Among patients who relapsed after initial CR, 22 of 54 (41%) achieved a second CR following retreatment with conventional chemotherapy approaches. The only factors which were significant in predicting for second CR were sex (female) and age (< 60 years), In both subgroups, patients who achieved CR following 'salvage' therapy survived significantly longer than those who responded less favourably. These findings emphasise the fact that response to treatment is the major predictor of survival among patients with indolent non-Hodgkin's lymphomas.