A relapse or recurrence after treatment occurs when laboratory values and physical signs and symptoms begin to trend in a deteriorating direction. These signs and symptoms may be quite similar to those that led to initial treatment. At this point, patients and their hematologist-oncologists are confronted with choosing the next appropriate course of action, be it continued periodic monitoring or re-treatment, which is sometimes referred to as salvage therapy.
The severity of symptoms, overall health condition, and quality of life will factor into the decision of when to begin re-treatment. The question becomes: Which treatment to choose? In general, if a patient has had good results with a prior therapy that led to a significant period of response (2 years or more), then a repeat treatment with the same therapy may be appropriate. If a prior therapy was not very effective or the response period was short, a different type of therapy may be indicated.
Fortunately, the choices of treatments for relapsed patients are many and are continually increasing. At the bottom of this page is a 30-minute video presented at the 2015 IWMF Educational Forum by Dr. Sheeba Thomas of MD Anderson Cancer Center outlines treatment options for relapsed disease. Patients also might want to consider participating in a clinical trial. It is perfectly appropriate when weighing treatment options following relapse to consult with a WM expert for a second opinion.