While the majority of tumor recurrences appear within 2 years, late relapse has been reported, and lifelong marker, radiologic, and physical examination are recommended.
The adjuvant chemotherapy series is too small to draw conclusions about the risk of chemotherapy-induced secondary malignancies, impact on fertility, or risk of late relapse.
Patients whose initial remission after chemotherapy was longer than 1 year (late relapse) have long-term survival with salvage chemotherapy of 22% to 71%.
Family letters, when they mention him, usually either hopefully discuss his latest release from habit or mourn his latest relapse.
The two patients who had a late relapse died, and in another patient death was not related to lymphoma.
The risk of late relapse is higher in patients with a divergent histology of both indolent and aggressive disease.
Other diseases may prove to have a multiple plateaus, so that what was once hailed as a "cure" results unexpectedly in very late relapses.
About 5-10% of patients have one or more late relapses, in which case they are then classified as having chronic inflammatory demyelinating polyneuropathy (CIDP).
Hypnozoites are responsible for long incubation and late relapses in P. vivax infections, although their existence in P. ovale is uncertain.
The risk of relapse decreases substantially over time, though late relapses are not uncommon.