Systematic Restaging in Non-Hodgkin’s Lymphoma: The Need to Define Complete Remission

Abstract

Improved treatment programs for lymphoma have led to the hope of cure for many patients [5, 7, 17]. In the past, treatment was often palliative, and the need to rigorously define the quality of response was small. Now, however, the majority of patients experience the disappearance of clinical symptoms and signs of disease, and accordingly a strong need has emerged to define the “completeness” of remission as an endpoint to treatment (with prognostic value) and as a basis for comparing the relative efficacy of various therapeutic programs. Accordingly, a plan for systematic and thorough reevaluation of all patients in apparent complete remission was incorporated into the latest Southwest Oncology Group (SWOG) trial of induction therapy for patients with advanced stages of non-Hodgkin’s lymphoma (NHL). We have previously reported the initial findings of “systematic restaging” for assessing the completeness of response in these patients [11]. This paper will extend these observations to a larger number of patients with NHL who have been restaged and will also examine the impact of restaging upon their ensuing course.