A more favourable clinical course of lymphoma relapsing after high-dose therapy: evidence of tumour heterogeneity?

Patients with Hodgkin's disease (HD) or large cell lymphomas who relapse af ter conventional chemotherapy have a poor prognosis without high-dose chemo therapy and stem cell transplantation (HDCT). Patients who relapse after HD CT have an extremely poor outcome, In the present study we describe four pa tients with relapsed HD (n=1) and large cell lymphomas (n=3) after HDCT. Al l had an aggressive clinical course before HDT. At relapse, however, they a ll have had prolonged remissions and/or spontaneous regressions on mild or no treatment, Possible explanations could be selection of less malignant cl ones or a lymphoma controlled by the immune system. The mechanisms are, how ever, unknown but warrant further studies of the molecular biology in these and similar cases.