Relapsed and Refractory Lymphoma

Unfortunately, sometimes lymphoma can come back after treatment (relapses). This can occur days, weeks, months or years after the treatment has finished.. Sometimes lymphoma does not respond to treatment and this is called a refractory lymphoma.

On this page:

Relapsed or Refractory lymphoma factsheet PDF

What is relapsed lymphoma?

Relapsed lymphoma is lymphoma that comes back after treatment and a period of remission. Remission is where there was no evidence of lymphoma on tests and scans.

Relapse can occur if there are lymphoma cells left in the body after treatment as a small amount of lymphoma cells may not be detected by standard tests. It is also possible to relapse after a partial or complete remission.  

For some lymphomas including Hodgkin lymphoma and some highly aggressive (fast growing) non-Hodgkin lymphoma a relapse is less likely but if they do relapse it is usually within a couple of years. 

Indolent (slow growing) non-Hodgkin lymphomas grow slowly, and treatments usually kills the lymphoma cells, but it is possible for some cancer cells to remain . It is common for indolent non-Hodgkin lymphoma to relapse and further treatments can be used.

How do you know if the lymphoma has relapsed?

Lymphoma may return in the same part of the body or it may affect a different part of the body.  Symptoms may be the same as before or new symptoms may be experienced.

Symptoms may include:

  • New or lymph nodes or lumps that are not related to an infection or illness
  • Drenching night sweats
  • Unexplained weight loss
  • Fatigue that is worse than normal
  • Itching
  • Skin rash
  • Diarrhoea 
  • Unexplained pain or discomfort

What happens if lymphoma relapses

  • Biopsy of new enlarged lymph nodes or lumps
  • Blood tests
  • Positron emission tomography (PET) scan
  • Computed tomography (CT) scan
  • Lumbar puncture if lymphoma is suspected in central nervous system

What is refractory lymphoma?

Refractory lymphoma is lymphoma that has not responded to initial treatment or the lymphoma gets worse or stays the same.

Sometimes a scan part-way through treatment shows that the treatment is not working as well as hoped.

We also know from research, that not everyone responds the same way to various treatments. It is not fully understood why this is the case. Research into genes and the genetic makeup of various cancers is being researched to see why some people respond to treatments and why others do not. This may be due to some specific gene mutations.  

Patients who have refractory disease may be offered a different type of treatment than was first given.  

Some treatment options for relapsed or refractory lymphoma

This is a list of some of the treatment options for relapsed lymphoma.  Treatment options are changing fast as researchers understand lymphoma further and new treatments are introduced.  Check specific subtypes to learn more

  • Clinical trial participation
  • Combination chemotherapy
  • Salvage chemotherapy (high dose chemotherapy)
  • Stem cell transplant (autologous & allogeneic)
  • Targeted therapy
  • Immunotherapy
  • Biological medicines
  • Radiotherapy
  • Chimeric antigen receptor (CAR) T-cell therapy

Clinical trials

There are many treatments that are currently being tested in clinical trials in Australia and around the world for patients with both newly diagnosed and relapsed lymphoma.

For more info see
Understanding Clinical Trials

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