Recurrence statistics

Is it more likely after "double hit" lymphoma (DBLCL) to get follicular lymphoma or a repeat of DBLCL?

After successful treatment for Diffuse Large B-Cell Lymphoma (DLBCL), it is significantly more likely to have a relapse of the same DLBCL rather than develop follicular lymphoma. While DLBCL can arise from follicular lymphoma (transformation), the reverse is not typical, and relapse usually presents as the same aggressive histology. 

PubMed Central (PMC) (.gov)

Key Findings on DLBCL Recurrence:

Relapse Probability: Approximately 30% to 40% of patients with DLBCL will experience a relapse, generally within the first two years of finishing treatment.

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PET scan

 Yet another PET scan! I was hoping to go for two years in between but Dr Ujjani wanted to make sure the shortness of breath I have been experiencing is not due to lymphoma. 

The patient summary says: 

History of follicular lymphoma diagnosed in 2013, treated with rituximab with good response. In 2021, developed high-grade transformation (double-hit lymphoma) with bulky retroperitoneal and nodal disease, treated with R-CHOP followed by dose-adjusted R-EPOCH, achieving complete response.

Now I have to wait for the result on MyChart or the TeleHealth appointment. I'm not worried because I think it's due to weight gain...or a heart problem, more worrisome.  

There is a cardiologist visit in my future!

Insurance game

My MediGap (supplemental) plan, Regence, is increasing this year by 22%. Medicare is also increasing but not by as much. Thanks, MAGA lunatics!

It makes me think about quitting it. But if I get sick with lymphoma again, how much would it cost me, beyond the 80% Medicare would pay? 

I had no idea so I tried to look it up. So 20% of the probable maximum of $141,000 would be $28,000. I would save almost $3,000 by not paying for Regence. Health insurance in this country is such a guessing game! I guess I better stick with Regence. 

Studies on Dose-Adjusted R-EPOCH (DA-EPOCH) show costs often exceed $100,000 for the full treatment, which includes medications (rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin) and administration.

It would be more for in-hospital treatment,  perhaps $141,000.