Surveillance investigations after high-dose therapy with stem cell rescue for recurrent follicular lymphoma have no impact on management

Background: The impact of active surveillance, comprising an annual CT scan and bone marrow biopsies, in the follow-up of patients after high-dose therapy (HDT) with autologous stem cell rescue for recurrent follicular lymphoma was analyzed.Design and Methods: Seventy-one of 99 patients who received HDT commenced on the surveillance program. Response duration, time-to-next-treatment and overall survival (OS) were compared, according to whether disease progression had been diagnosed on the basis of surveillance investigations or clinical grounds.Results: After a median follow-up of 16 years, progression was documented by surveillance in 16 patients and clinically in 18, the median response duration being 2.4 and 2.3 years, respectively (p=NS). Ten patients with a clinical relapse started treatment immediately contrasting with one patient who had a surveillance relapse. Five patients with relapses on surveillance investigations have not required treatment after a median follow-up of 18 years, whereas all but 2 patients with a clinical relapse have been treated. The median time-to-next-treatment was 7 years for patients with a surveillance relapse and 4 years for those with a clinical relapse (p=0.03). OS was not significantly different.Conclusions: Surveillance investigations have no impact on management and do not improve the outcome of this population