Factors Contributing to Risk of Lymphoma Returning
- Biology of the tumor
- Older age
- Cancer stage, aggressiveness, and response to chemotherapy
- Depending on these factors, the risk of relapse after therapy could range from about 20% to 50%
“For the type of lymphoma that we’re talking about diffuse large B-cell lymphoma there are a number of factors that we look at to wonder what might be a person’s risk of relapsing once they’ve had their standard upfront therapy,” he says. He notes that the first treatment is typically a combination of chemotherapy, the targeted drug rituximab (Rituxan), plus the steroid prednisone, known collectively as R-CHOP.
Risk Factor: Biology of the Tumor
Read MoreThough relatively rare, genetic alterations like these increase the risk of relapse. Patients with these translocations should speak with their doctors about ways to reduce the risk of having their cancer come back, he says. They often get a different initial chemotherapy treatment called dose-adjusted R-EPOCH, rather than R-CHOP.
Risk Factor: Age
Age is another factor that can increase relapse risk. “It turns out that the older a patient is, the higher the risk of relapse occurring,” Dr. Jain says. He notes that there are likely two reasons for this.
One reason may be that older patients have a bit more difficulty getting all of the chemotherapy and other treatments their doctor prescribed, he says. Also, “The biology of the lymphoma seems to be a bit more chemo-resistant and more aggressive the older the patients are.”
Risk Factor: Cancer Stage
Additional risk factors include the stage of the cancer. Cancers that are at a more advanced stage tend to be more aggressive and harder to treat. Lymphomas are often at an advanced stage, Dr. Jain says. That’s because they start in immune cells, which are all over the body.
What to Do If You’re at Risk for a Relapse
Your doctor will look at these and other factors to determine your relapse risk. Overall, “We think that the risk of relapse after initial therapy … could be anywhere from 20% to maybe 50%,” Dr. Jain says. This is where vigilance is important.
Your oncologist will continue to monitor you for a few years after your treatment ends. During these regular follow-up visits, your doctor will give you physical exams that include an assessment of your lymph nodes, ask about your symptoms, give you blood tests to check for signs of cancer, and possibly perform imaging scans.
In between visits, let your doctor know if you have any new symptoms. If your cancer does return, catching it early will offer you the best hope of a second treatment success.
Learn more about SurvivorNet's rigorous medical review process.
