Late Relapse

Disease recurrence more than 1 year off therapy is usually responsive to retrieval chemotherapy. Thus, major disease regressions can be expected, even with use of the similar agents or regimens that comprised induction following the initial diagnosis; however, different consolidation measures are required to offer any chance for long-term control, which is still very limited in patients who have already received myeloablative therapy. For patients who achieve a second complete remission, there is a potential role for the same repertoire of treatments for minimal residual disease mentioned above, including retinoids, anti-GD2 antibodies, and local radiotherapy.

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