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Cures that are apparent when treatment ceases may later relapse, with subsequent requirement for further therapy.
Pathological complete response to primary medical treatment has clearly been correlated with long-term prognosis [ 27]; however, several patients achieving a complete response may later relapse.
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Thus the persistence of an active PGE2 pathway despite rituximab treatment may contribute to later relapse.
Twentypercentt of patients died in first or later relapse.
Patients with later relapses can expect to do particularly well, and so effort should be made to diagnose later relapse at an early stage.
Three of 26 patients had improvement for a period, later relapsed, and required subsequent surgery.
Further research is needed in order to examine the possibility that higher baseline anxiety levels may represent a risk factor for later relapse.
Intravenous regimens tend to give a lower total dose and have fewer side effects, but may later give a higher rate of relapse [ 13].
In most reports, transplantation is better than continuation chemotherapy in early marrow relapse, but its role in later relapse is less clear.
Furthermore, the efficacy in patients with early relapse (within first year) after first ASCT vs later relapse was explored.
Later the early stage may relapse, or latency may be terminated by the late stage of the disease, which is characterized by soft gummy ulcers of the skin, the bones, and the centre of the face, a patchy loss of skin pigment, and other conditions.
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