Relevant bibliographies by topics / Relapse

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Academic literature on the topic 'Relapse'

Author: Grafiati
Published: 4 June 2021
Last updated: 9 June 2025

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Journal articles on the topic "Relapse"

1

Wudhikarn, Kitsada, Pinyo Rattanaumpawan, and Margarida M. Silverman. "Characterization of Extramedullary Relapse After Allogeneic Stem Cell Transplant in Acute Myeloblastic Leukemia: Distinct Entity and Outcome." Blood 120, no. 21 (November 16, 2012): 1972. http://dx.doi.org/10.1182/blood.v120.21.1972.1972.

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Abstract Abstract 1972 Introduction: Relapse after allogeneic stem cell transplant (SCT) is a major cause of morbidity and mortality of acute myeloblastic leukemia (AML) patients. Most relapses primarily involve bone marrow whereas extramedullary (EM) relapses are relatively uncommon. Data on natural history, optimal management and treatment outcome in EM relapse following allogeneic SCT are limited. Method: We retrospectively reviewed 130 AML patients who underwent allogeneic SCT at the University of Iowa Hospitals and Clinics between January 2003 and December 2010. Pre-transplant baseline characteristics and post-transplant variables were abstracted. Patterns of relapse after allotransplant, management and outcome were reported. Result: Among 130 AML patients who underwent allogeneic SCT, we identified 61 (47%) relapsed AML after allotransplant. Of 61 relapsed cases, there were 7 (12%) isolated EM, 44 (72%) isolated bone marrow (BM) and 10 (16%) concurrent BM + EM relapses. Among 17 EM relapsed cases, there was a higher prevalence of acute monocytic leukemia subtype (41.5% VS 2.3%, odd ratio [OR] = 4.1, p=0.03), moderate to severe chronic graft versus host disease (GVHD) (35.3% VS 4.6%, OR=2.3, p=0.01) compared to non-EM relapsed patients. Median time to relapse in EM cases was significantly longer than non-EM group (428 days, 95% confidence interval [CI] 203–652 VS 162 days, 95%CI 100–231, p=0.003). EM relapse sites included 1 pulmonary (6%), 3 (18%) genitourinary, 7 (41%) skin/soft tissue, 2 (12%) gastrointestinal and 4 (23%) multisystem involvement. Of 17 EM relapsed cases, 12 (71%) had immunosuppression withdrawn, 13 (76%) received systemic chemotherapy with/without donor lymphocytic infusion and 7 (41%) had radiation therapy to EM relapse sites. The 6-month survival after relapse of EM patients was significantly higher than non-EM group (29.4%, 95%CI 10.7–51.2 VS 6.8%, 95%CI 1.8–16.7, p=0.014). Further subgroup analysis showed that isolated EM relapsed group had significantly higher 6-month survival after relapse than systemic relapse group (isolated BM or concurrent EM + BM) (42.9%, 95%CI 9.8–73.4 VS 9.3%, 95%CI 3.4–18.7, p=0.008). Table 1 compares the management and outcome between isolated EM relapse and concurrent BM + EM relapse. At the time of analysis, three (18%) of 17 EM relapsed cases (all of which were isolated EM patients) achieved disease controlled/remission and remained alive at 10, 13 and 19 months following relapse respectively. Cox proportional hazards analysis identified low hematopoietic cell transplant comorbidity index (HR 0.86, 95%CI 0.74–0.99, p=0.038), relapse after 180 days (HR 0.05, 95%CI 0.01–0.16, p<0.001) and presence of chronic GVHD (HR 3.57, 95%CI 1.02–12.45, p=0.04) to be associated with favorable survival after relapse. Conclusion: EM relapse of AML after alloSCT presents later than bone marrow relapse and occurs despite the presence of GVHD, especially chronic GVHD. As transplant survival has improved, increasing EM relapses have been observed. Although appropriate management is unknown, prognosis of EM relapse is better than systemic relapse and durable remission can be achieved. Disclosures: No relevant conflicts of interest to declare.
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Wang, Yucai, Umar Farooq, Brian K. Link, Melissa C. Larson, Rebecca L. King, Matthew J. Maurer, Cristine Allmer, et al. "Late Relapses in Patients With Diffuse Large B-Cell Lymphoma Treated With Immunochemotherapy." Journal of Clinical Oncology 37, no. 21 (July 20, 2019): 1819–27. http://dx.doi.org/10.1200/jco.19.00014.

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PURPOSE In patients with diffuse large B-cell lymphoma (DLBCL), most relapses occur within the first 2 years of diagnosis. We sought to define the rate and outcome of late relapses that occurred after achieving event-free survival at 24 months (EFS24). METHODS We prospectively followed 1,324 patients with newly diagnosed DLBCL from 2002 to 2015 and treated with immunochemotherapy. Cumulative incidences of late DLBCL and indolent lymphoma relapses were analyzed as competing events. Postrelapse survival was defined as time from first relapse to death from any cause. RESULTS In 847 patients who achieved EFS24, the cumulative incidence of late relapse was 6.9% at 3 years, 9.3% at 5 years, and 10.3% at 8 years after EFS24. The incidence of DLBCL relapse was similar in patients with DLBCL alone at diagnosis (6.3% at 5 years), compared with patients with concurrent indolent lymphoma at diagnosis (5.2%; P = .46). However, the rate of indolent lymphoma relapse was higher in patients with concurrent indolent lymphoma (7.4% v 2.1% at 5 years; P < .01). In patients with DLBCL alone, the rate of DLBCL relapse was similar in the germinal center B-cell–like (GCB) (4.1% at 5 years) and non-GCB (4.0%; P = .71) subtypes, whereas the rate of indolent lymphoma relapse was higher in patients with the GCB subtype (3.9% v 0.0% at 5 years; P = .02). Postrelapse survival was inferior for patients who relapsed with DLBCL than for those who relapsed with indolent lymphoma (median 29.9 months v unreached; P < .01). CONCLUSION Patients with DLBCL with a concurrent indolent lymphoma and those with the GCB subtype had a higher rate of late relapse, owing to increased relapses with indolent lymphoma. Patients who relapsed with DLBCL had a worse prognosis than those who relapsed with indolent lymphoma.
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Ganzel, Chezi, Wang Xin Victoria, Adele K. Fielding, Jacob M. Rowe, Susan M. Richards, Georgina Buck, Rajesh Chopra, et al. "in Philadelphia-Chromosome-Negative Acute Lymphoblastic Leukemia, Late Relapses Are Not Uncommon, Occur Mostly in Patients at Standard Risk and Have a Relatively Favorable Outcome. Results of the International ALL Trial: MRC Ukallxii/ECOG E2993." Blood 126, no. 23 (December 3, 2015): 795. http://dx.doi.org/10.1182/blood.v126.23.795.795.

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Abstract This study was coordinated by the ECOG-ACRIN Cancer Research Group (Robert L. Comis, MD and Mitchell D. Schnall, MD, PhD, Group Co-Chairs) and the Medical Research Counsel, United Kingdom, and supported in part by Public Health Service Grants CA180820, CA180794, CA180790, CA189859, CA180853, CA180791, and from the National Cancer Institute, National Institutes of Health and the Department of Health and Human Services. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. Background: Late relapse in acute leukemia is considered a relatively rare event. Patients with acute myeloid leukemia (AML) are often considered cured of the disease at 3 years, but information regarding adult acute lymphoblastic leukemia (ALL) patients is scarce. Data are presented from one of the largest prospective adult ALL studies, the MRC UKALLXII/ECOG E2993, to evaluate the rate and characteristics of late relapse in ALL. For this purpose, late relapse was defined, arbitrarily, as relapse 3 years post achievement of complete remission (CR) and very late relapse was defined as relapse > 5 years from CR. Methods: The UKALLXII/ECOG E2993 was an international ALL trial conducted jointly by the MRC in the United Kingdom and ECOG in the United States. All patients received identical induction therapy, followed by central nervous system prophylaxis. Patients with a sibling donor (or a matched unrelated donor in Philadelophia-chromosome-positive ALL) were assigned to receive an allogeneic hematopoietic stem cell transplant (HSCT); all others were randomized to undergo an autologous transplant or protracted standard consolidation/ maintenance therapy. The study accrued 2109 patients from 1993 to 2008. Following relapse, patients were followed for survival. For this report only patients registered before the tyrosine kinase inhibitors era are included in the analysis. Results: 1518 study patients were eligible for this analysis, 1208 (79.6%) Philadelphia-chromosome negative (Ph-neg) and 267 (17.5%) Philadelphia-chromosome positive (Ph-pos). 1381 (91%) of the patients achieved CR; 93% of the Ph-neg and 82% of the Ph-pos. 572 patients (37.7%) underwent allogeneic HSCT. The median duration of follow-up of patients who achieved CR was 10 years. Among the 1381 patients who achieved CR, 626 (45.3%) had a documented relapse; 566 (90.4%) relapsed within 3 years of CR and 60 (9.6%) relapsed beyond 3 years ('late relapse') (Figure 1). Among these 60 patients, 18(2.9%) relapsed after 5 years ('very late relapse'). Table. Patients n CR All relapses Relapses< 3 years Relapses≥ 3 years Relapses≥ 5 years All patients 1518 1381 (91%) 626 (45.3%) 566 (90.4%) 60 (9.6%) 18 (2.9%) Ph-neg 1208 (79.6%) 1123 (93%) 485 (40.1%) 429 (88.5%) 56 (11.5%) 17 (3.5%) Ph-pos 268 (17.5%) 219 (82%) 124 (56.6%) 122 (98.4%) 2 (1.6%) 1 (0.8%) Relapse beyond 3 years occurred in 4.3% of all who achieved CR, in 5% of Ph-neg and 0.01% of Ph-pos patients. Among the 60 late relapses, the median time to relapse was 46 months. 61.7% of the late-relapse patients were males, median age was 32 years, 88.3% were B-lineage ALL and the median white cell count at diagnosis was 6000/ul. 56.7% were in cytogenetic standard risk, 8.3% at high risk and the data of 35% are unknown. The median survival for the late relapse patients was longer than for those who relapsed within 3 years. The overall survival (OS) of the 56 Ph-neg patients who relapsed beyond 3 years is shown in Fig 2. Table.Relapse > 3 yearsRelapse > 3 yearsMedian survival from relapse (months)5.411.23-year OS from relapse6.5%29%5-year OS from relapse5.6%19% Conclusions: Late relapses in adults with Ph-neg ALL are not uncommon. About 10% of relapses occur beyond 3 years and 4.3% of all ALL patients who achieved a CR can expect to have a late relapse. These data are in contrast to AML where only 1% of patients relapse beyond 3 years (Watts JM et al, 2014). Most of the late relapse patients were at standard risk and appeared to have a relatively favorable outcome post relapse. Patients with ALL, particularly those who are Ph-neg, cannot be considered as cured at 3 years and need to be closely followed. Figure 1. Time to relapse of Ph-pos and Ph-neg ALL Figure 1. Time to relapse of Ph-pos and Ph-neg ALL Figure 2. Survival from relapse for Ph-neg patients who relapsed after 3 years from CR. Figure 2. Survival from relapse for Ph-neg patients who relapsed after 3 years from CR. Disclosures Rowe: Amgen: Consultancy; BioSight Ltd.: Consultancy, Membership on an entity's Board of Directors or advisory committees; BioLineRx Ltd.: Consultancy. Douer:Gilead: Consultancy.
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Platte, Victoria, Anika Bergmann, Barbara Hildebrandt, Dagmar Wieczorek, Esther Schuler, Ulrich Germing, Jennifer Kaivers, et al. "Clinical and Cytogenetic Characterization of Early and Late Relapses in Patients Allografted for Myeloid Neoplasms with a Myelodysplastic Component." Cancers 14, no. 24 (December 18, 2022): 6244. http://dx.doi.org/10.3390/cancers14246244.

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An improved understanding of relapse kinetics is required to optimize detection and treatment strategies for the post-transplant relapse of myeloid neoplasms. Therefore, we retrospectively analyzed data from 91 patients allografted for MDS (n = 54), AML-MRC (n = 29) and chronic myelomonocytic leukemia (CMML, n = 8), who relapsed after transplant. Patients with early (<12 months, n = 56) and late relapse (>12 months, n = 35) were compared regarding patient-, disease- and transplant-related factors, including karyotype analyses at diagnosis and relapse. After a median follow-up of 17.4 months after relapse, late relapses showed improved outcomes compared with early relapses (2-yr OS 67% vs. 32%, p = 0.0048). Comparing frequency of distinct patient-, disease- and transplant-related factors among early and late relapses, complex karyotype (p = 0.0004) and unfavorable disease risk at diagnosis (p = 0.0008) as well as clonal evolution at relapse (p = 0.03) were more common in early than in late relapses. Furthermore, patients receiving transplant without prior cytoreduction or in complete remission were more frequently present in the group of late relapses. These data suggest that cytogenetics rather than disease burden at diagnosis and transplant-related factors determine the timepoint of post-transplant relapse and that upfront transplantation may be favored in order to delay relapse.
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Stolpa, Weronika, Magdalena Zapała, Bartosz Zwiernik, and Agnieszka Mizia-Malarz. "Relapses Children’s Acute Lymphoblastic Leukemia, Single Center Experience." Children 9, no. 12 (November 30, 2022): 1874. http://dx.doi.org/10.3390/children9121874.

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The prognosis in children and adolescents with relapsed ALL, despite intensive therapy, including hematopoietic stem cell transplantation, is still challenging. This study aims to analyze the incidence of relapsed ALL and survival rates in correlation to the risk factors. Materials and methods: 125 pediatric patients with ALL diagnosed in our department between 2000-2018; age 1–18 years old (median 6.4); female 53.6 % vs. male 46.4 %. Results: 19 pts (15.2%) were diagnosed with a relapse. Three pts (15.8%) had been diagnosed with very early relapses (2/3 T-ALL), 12 pts (63.1%) as an early relapse, and 4 pts (21.1%) as a late relapse. Bone marrow was the most frequent relapses localization. The five-year survival has been achieved by six patients (31.6%). A significant difference was found in regard to the five-year overall survival and relapse type (p < 0.05). The group with very early relapses (3/3; 100%) has not reached the five-year survival. Conclusions: 1. The main prognostic factor in children’s ALL relapses is still the time of the onset of the relapse. 2. The T lineage acute lymphoblastic leukemia is a worse prognostic factor. 3. The analysis of the above relapse risk factors alongside cytogenethic markers and flow cytometry or polymerase chain reaction minimal residual disease is very important for first-line chemotherapy improvement and a more personalized choice of therapy for ALL patients.
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Nagane, Motoo, Nobuyoshi Sasaki, Yuki Yamagaishi, Kuniaki Saito, Keiichi Kobayashi, and Hirofumi Nakatomi. "CTNI-81. REAL-WORLD TREATMENT RESULTS OF RELAPSED PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA TREATED BY MEDICAL THERAPIES." Neuro-Oncology 25, Supplement_5 (November 1, 2023): v96—v97. http://dx.doi.org/10.1093/neuonc/noad179.0363.

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Abstract Recurrence of primary central nervous system lymphoma (PCNSL) is a condition which often leads to morbidity and mortality. Consensus regarding the optimal treatment regimen for relapsed PCNSL has not been achieved due to the rarity of the disease. In this study, we conducted a retrospective, single-institution study to investigate real world treatment results of relapsed PCNSL treated by several medical therapeutic regimens. Relapsed PCNSL patients treated at the authors’ institution were identified, and progression-free survival (PFS), overall survival (OS) were analyzed among patients treated by medical therapies. Patients treated by radiotherapy, treated for intraocular or systemic relapses, or best supportive care, were excluded from the survival analysis. 83 patients with first, 44 with second, 25 with third relapse were identified. Upon each relapse, number of patients who received medical therapies for CNS lesions, radiotherapy, treatment for intraocular or systemic relapse, and best supportive care were 48 (57.8%), 5(6%), 4(4.8%), 26(31.3%) (first relapse), 31(70.5%), 3(6.8%), 1(2.3%), 9(20.5%) (second relapse), 13(52.0%), 0, 1(4%), 11(44.0%) (third relapse), respectively. A total of 101 CNS relapses were treated by medical therapies, and PFS (months), OS (months) of the four groups of treatments (rituximab, methotrexate, procarbazine and vincristine [R-MPV], methotrexate [MTX], tirabrutinib, and others) were as follows. PFS: 13.0, 4.5, 2.7, 3.0, and OS: 70.0, 26.4, 51.2, 9.7 (all relapse). PFS: 12.7, 7.0, 3.0, 3.2, and OS: 58.9, 33.1, not reached(n/r), 16.1 (first relapse). PFS: 34.3, 3.9, 25.3, 1.5, and OS: n/r, 28.1, 25.5, 7.5 (second relapse). PFS: 10.1, 3.9, 2.4, 2.9, and OS: 14.9, 22.3, n/r, 8.1 (third relapse). In relapsed PCNSL, favorable PFS was observed in patients treated by R-MPV. Favorable OS was also observed in tirabrutinib, which might suggest that tirabrutinib failure were effectively salvaged by R-MPV. R-MPV might confer better prognosis in relapsed PCNSL.
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Barz, Malwine J., Jana Hof, Stefanie Groeneveld-Krentz, Jui Wan Loh, Annabell Szymansky, Kathy Astrahantseff, Arend von Stackelberg, et al. "Subclonal NT5C2 mutations are associated with poor outcomes after relapse of pediatric acute lymphoblastic leukemia." Blood 135, no. 12 (March 19, 2020): 921–33. http://dx.doi.org/10.1182/blood.2019002499.

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Abstract Activating mutations in cytosolic 5′-nucleotidase II (NT5C2) are considered to drive relapse formation in acute lymphoblastic leukemia (ALL) by conferring purine analog resistance. To examine the clinical effects of NT5C2 mutations in relapsed ALL, we analyzed NT5C2 in 455 relapsed B-cell precursor ALL patients treated within the ALL-REZ BFM 2002 relapse trial using sequencing and sensitive allele-specific real-time polymerase chain reaction. We detected 110 NT5C2 mutations in 75 (16.5%) of 455 B-cell precursor ALL relapses. Two-thirds of relapses harbored subclonal mutations and only one-third harbored clonal mutations. Event-free survival after relapse was inferior in patients with relapses with clonal and subclonal NT5C2 mutations compared with those without (19% and 25% vs 53%, P < .001). However, subclonal, but not clonal, NT5C2 mutations were associated with reduced event-free survival in multivariable analysis (hazard ratio, 1.89; 95% confidence interval, 1.28-2.69; P = .001) and with an increased rate of nonresponse to relapse treatment (subclonal 32%, clonal 12%, wild type 9%, P < .001). Nevertheless, 27 (82%) of 33 subclonal NT5C2 mutations became undetectable at the time of nonresponse or second relapse, and in 10 (71%) of 14 patients subclonal NT5C2 mutations were undetectable already after relapse induction treatment. These results show that subclonal NT5C2 mutations define relapses associated with high risk of treatment failure in patients and at the same time emphasize that their role in outcome is complex and goes beyond mutant NT5C2 acting as a targetable driver during relapse progression. Sensitive, prospective identification of NT5C2 mutations is warranted to improve the understanding and treatment of this aggressive ALL relapse subtype.
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Abu Shanap, Mayada, and Iyad Sultan. "Outcome of Relapsed Childhood Acute Lymphoblastic Leukemia in Resource-Poor Country : Warrants the Need for Immunotherapy." Blood 144, Supplement 1 (November 5, 2024): 5857. https://doi.org/10.1182/blood-2024-206147.

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Introduction: The overall survival (OS) rate for children with acute lymphoblastic leukemia (ALL) treated at King Hussein Cancer Center is approximately 80%, aligning with published results of the Total XV regimen. Method: From December 2003 until August 2023, children/adolescents (<18 years at diagnosis) with ALL in first and subsequent relapses were studied. Treatment of relapse consisted of reinduction regimens followed by intensive continuation therapy and hematopoietic stem cell transplantation (HSCT) in selected patients. The poor prognostic group (PPG) included patients who did not achieve remission after salvage chemotherapy and were referred to palliative care. Results: The study included 160 patients with a median age of 5 years (range: 0.4-19.8 years), followed for a median of 71 months (range: 4-248 months). Sites of relapse were: bone marrow (BM) in 64%(N=103) of the patients, combined relapse in 19 %( N=30) and isolated extra-medullary Relapse (IEM) relapse 17%(N=27). Complete remission (CR2) rates for all patients were 64% and vary according to time and site of relapse (100% for IEM, 56% for isolated BM/combined: 90% for late relapses, and 39% for early/very early relapses). The estimated 5-year-EFS and OS for the whole group were 30% and 40 %, respectively. Five-year-OS for patients with BM relapse was 29%, combined relapse 58%, and IEM 66%. Five-year-OS for patients with very early relapse was 12%, early relapse 36%, and late 74%. Forty patients (39%) continued on chemotherapy after achieving CR2, and sixty-two patients (61%) underwent HSCT, with 60 (59%) alive in continuous complete remission (CCR) at last follow-up. All patients (N=58) in the PPG died of the disease. In univariable analysis, worse OS was observed in patients <1 or≥10-years at diagnosis, those T-cell-immunophenotype, CNS 3 at diagnosis, BM and very early relapses. In multivariable analysis : age (p=0.02), site of Relapse( p=0.019) and time of relapse(p=0.009) were prognostic. In univariable analysis, worse EFS was observed in patients <1 or≥10-years at diagnosis, T-cell-immunophenotype, CNS 3 at diagnosis, unfavorable cytogenetic at diagnosis, BM and very early relapses. In multivariable analysis Site of Relapse ( p=0.02)and time of relapse(p<0.001) were prognostic. Conclusions At our center, more than one-third of relapsed ALL patients were cured. However, survival rates are low in high-risk relapsed ALL (very early and isolated BM relapses). Conventional chemotherapy and adequate supportive care failed to salvage this high-risk group, indicating the need for immunotherapy as a bridge to allogeneic hematopoietic stem cell transplantation.
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Maxwell, Rebecca, Beate Häberle, Roland Kappler, Dietrich von Schweinitz, Mark Rassner, Julia von Frowein, and Irene Schmid. "Hepatoblastoma Relapse—Findings from the German HB99 Trial and the German Liver Tumor Registry." Cancers 16, no. 4 (February 6, 2024): 696. http://dx.doi.org/10.3390/cancers16040696.

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Survival rates for HB patients have improved; however, outcomes for patients who relapse remain poor. A retrospective review of information gathered for the HB99 study and the German Liver Tumor Registry identified 25 relapse patients (6.9%, 25/362). The median time from initial diagnosis to first relapse was 13 months (range: 5–66 months). Two patients relapsed >36 months after initial diagnosis. A total of 68% (17/25) of relapses were metastatic, 24% local, and 8% combined. 67% of local relapses were alive at the last follow-up, in contrast to 53% of metastatic and 0% of combined relapses. At the last follow-up, 73% (8/11) of patients with lung relapses were still alive (0/4 with peritoneal, 1/2 with CNS involvement). A total of 20% of the patients had AFP-negative relapses, 64% of the relapse patients achieved a second complete remission, 69% were still in complete second remission at the last follow-up (median FU of 66 months), and 83% (5/6) of irinotecan-naïve patients who received relapse treatment including irinotecan were in second complete remission at the last follow-up. The 3-year overall survival/event-free survival from relapse was 63%/48% respectively. There is a good chance that HB patients will achieve a second remission despite a first relapse. However, patients who suffer further relapses tend to have a poorer prognosis.
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Hill, Rebecca, Stacey Richardson, Edward Schwalbe, Debbie Hicks, Janet Lindsey, Stephen Crosier, Gholamreza Rafiee, et al. "MBRS-44. TIME, PATTERN AND OUTCOME OF MEDULLOBLASTOMA RELAPSE ARE ASSOCIATED WITH TUMOUR BIOLOGY AT DIAGNOSIS AND UPFRONT THERAPY: A COHORT STUDY." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii405—iii406. http://dx.doi.org/10.1093/neuonc/noaa222.553.

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Abstract Disease relapse occurs in ~30% of children with medulloblastoma, and is fatal in the majority. We sought to establish whether clinico-molecular characteristics at diagnosis are associated with the nature of relapse, subsequent disease-course, and whether these associations could inform clinical management. We surveyed the clinical features of medulloblastoma relapse (time-to-relapse, pattern-of-relapse, time-to-death and overall outcome) in 247 centrally-reviewed patients who relapsed following standard-upfront-therapies. We related these to clinico-molecular features at diagnosis, prognostic factors, and first-line/relapse treatment. Patients who received upfront craniospinal irradiation (CSI-treated) displayed prolonged time-to-relapse compared to CSI naïve patients (p<0.001). Similarly, in CSI naïve patients, CSI at relapse, alongside re-resection and desmoplastic/nodular histology, were associated with long-term survival. In CSI-treated patients, the nature of relapse was subgroup-dependent. Local-nodular relapse patterns were enriched in relapsed-MBSHH patients (p<0.001), but a notable proportion (65%) also acquired distant-diffuse disease (p=0.010). MBGroup3 relapsed quickly (median 1.3 years), MBGroup4 slowly (median 2.1 years). Distant-disease was prevalent in MBGroup3 and MBGroup4 relapses (90%) but, in contrast to relapsed-MBSHH, nodular and diffuse patterns of distant-disease were observed. Furthermore, nodular disease was associated with a prolonged time-to-death post-relapse (p=0.006). Investigation of second-generation MBGroup3/4 subtypes refined our understanding of heterogeneous relapse characteristics. Subtype VIII had prolonged time-to-relapse; subtype II a rapid time-to-death. Subtypes II/III/VIII developed a significantly higher incidence of distant-disease at relapse, whereas subtypes V/VII did not. The nature of medulloblastoma relapse are biology and therapy-dependent, providing immediate translational opportunities for improved disease management through biology-directed surveillance, post-relapse prognostication and risk-stratified selection of second-line treatment.
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Dissertations / Theses on the topic "Relapse"

1

Agboola, Shade. "Smoking relapse prevention : abstinence, relapse, current practice and effective interventions." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/43623/.

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Smoking remains a major cause of morbidity and mortality. In 2013/2014, 454,700 hospital admissions in the UK amongst persons 35 years and over were estimated to be attributable to smoking. This accounts for 4 per cent of all hospital admissions in this age group. In 2013, 17% (78,200) of all deaths in adults aged 35 and over were estimated to be caused by smoking[1]. Reducing smoking therefore, remains a major priority for governments and health systems like the UK National Health Service (NHS). Following the publication of the Government’s White Paper, Smoking Kills[2] in 1998, a comprehensive tobacco control strategy was implemented. This strategy was aimed at reducing uptake of smoking and increasing quitting among existing smokers, and involved a combination of population tobacco control interventions (such as price rises, an advertising ban and smoke-free legislation) combined with treatment for dependent smokers through the NHS. A Tobacco Control Plan for England was also produced in 2011 which explained the government’s strategy to reduce smoking through the new public health system[3]. This plan outlined commitments to implement legislation to end display of tobacco in shops, to encourage smokers to quit and remaining quit by using effective forms of support and implementing a policy of using tax to maintain the high price of tobacco. Effective forms of support may be behavioural, pharmacological or a combination of both[3]. In the UK, support is often delivered by stop smoking services (SSS), although smokers, who wish to, may obtain smoking cessation medication from their GP[4]. These SSS have been shown to be cost effective, but the majority, 85% of smokers attending the services, have relapsed by one year. The nature of nicotine addiction means that smoking is a chronic relapsing condition[5], with many smokers unable to sustain abstinence. Smoking relapse rates can be extremely high (up to 90% in the first 3 months)[6], and only 3%-5% of unsupported/untreated quitters maintain their quit attempt for 6 months or longer[7]. This high relapse rate reflects the addictive nature of cigarette smoking and underscores the importance of finding effective relapse prevention interventions for use in routine practice, which can be delivered alongside or after acute cessation has ended. There is no universally accepted definition of what interventions to prevent relapse to smoking (relapse prevention interventions - RPIs) should comprise; many smoking cessation programmes simply modify the content of existing, cessation-orientated support and deliver these as relapse prevention[8]. The paucity of information regarding provision of smoking relapse prevention is in contrast to the wide availability of evidence for the use of acute cessation treatments which has grown rapidly over recent decades. A variety of effective treatments now exist which can increase the chances of stopping smoking up to fourfold compared with no support[9], but research suggests that relapse prevention interventions and treatments are not as widely known or even used. At the time the research was conceived, there was very little information about the effectiveness of RPIs. A number of studies had investigated effectiveness of behavioural support, pharmacotherapies, and combination treatments, as forms of relapse prevention or maintenance treatment, and one Cochrane Review[8] found no evidence for the effectiveness of behavioural RPIs, but this may have been because the review combined smoking outcomes obtained at different follow-up time points after quitting and this may have obscured real effects of RPIs. The review found insufficient evidence for the effectiveness of extended treatment with bupropion and weak evidence for the effectiveness of nicotine replacement therapy for relapse prevention. There was, therefore, a need to examine current literature and synthesize data from a wide variety of studies, using a different approach from that used in the Cochrane Review to enhance interpretation of findings. In addition to ascertaining whether or not RPIs are effective, there was also a need to explore feasibility of provision within local Smoking Cessation Services. No study had explored feasibility of provision of RPIs within Stop Smoking Services, and whether these interventions would be acceptable to smokers trying to quit, mainly because the use of relapse prevention interventions in a local smoking cessation service was not only relatively new and unproven, there was also no information regarding smokers’ perceptions of relapse prevention interventions Abstinence and relapse during a quit process is still poorly understood, especially relapse after the use of a smoking cessation aid. A few studies had investigated patterns of relapse and abstinence in smokers who quit smoking unaided and two reviews[7 10] found that the majority of relapse occurred in the first two weeks of starting a quit attempt. The majority of smokers who wish to quit smoking use some form of evidence based treatment. It was therefore important to explore patterns of relapse in smokers who have attempted to quit smoking with the aid of a smoking cessation treatment. The work presented here is for the degree of PhD by publication and is based upon five publications in high quality peer reviewed journals between 2009 and 2015. I am the lead author on four of the included papers and the final and corresponding author on one paper. The research forms a coherent body of work informing the evidence base on smoking relapse prevention interventions (RPIs). This has contributed to the evidence base around four key aspects of smoking relapse prevention: knowledge, views and beliefs, effectiveness of smoking relapse prevention interventions, feasibility of delivery of RPIs within UK Stop Smoking Services, and abstinence and relapse patterns amongst smokers who quit smoking with the aid of a pharmacological smoking cessation treatment. Systematic reviews, meta-analysis, quantitative research and qualitative research were used to generate the data which supported the exploration of the four themes outlined below. Specifically, the published works have identified: • Knowledge, Understanding, Views and Beliefs: there was no shared understanding of what relapse prevention meant to Stop Smoking Service professionals or the kinds of interventions that should be used for this, but a willingness to provide such treatments was apparent. (Agboola SA, Coleman, T and McNeill, A. (2009). Relapse prevention in UK Stop Smoking Services: a qualitative study of health professionals' views and beliefs. BMC Health Services Research. 9:67 and Agboola SA, Coleman TJ, Leonardi-Bee J, McEwen A and McNeill A (2010). Provision of relapse prevention interventions in UK NHS Stop Smoking Services: a survey. BMC Health Services Research 10:214) • Effectiveness of smoking relapse prevention interventions: A pooled analysis of randomized controlled trials of nicotine replacement therapy, bupropion and varenicline showed that these interventions are effective for relapse prevention. A meta-analysis of four studies of nicotine replacement therapy found that smokers who used NRT for relapse prevention were 1.56 times more likely to remain abstinent at six months follow-up compared to placebo (95% confidence interval 1.16 to 2.11). A pooled analysis of four studies of bupropion showed evidence for effectiveness at long term follow-up (12 to 18 months) with an odds ratio of 1.49 (95% confidence interval 1.10 to 2.01). A single study of varenicline also demonstrated evidence for effectiveness for relapse prevention. (Agboola S, McNeill A, Coleman T and Leonardi-Bee, J (2010). A systematic review of the effectiveness of smoking relapse prevention interventions for abstinent smokers.<br>Addiction 105, 1362–1380) This was the first time that RPIs had been proven effective, and now that there appeared to be evidence of efficacy, it was appropriate to investigate feasibility of introducing these into routine clinical practice (next study). • Feasibility of delivering relapse prevention: A study investigating the feasibility, uptake and acceptability of offering nicotine replacement therapy (NRT) as a relapse prevention intervention (RPI) within UK Stop Smoking Services, showed that NRT can be added to existing treatment protocols, and that of 260 SSS clients who were eligible and offered this intervention, 44% (95% confidence interval 38% to 50%) accepted the offer. • Abstinence and relapse patterns: A pooled analysis of 19 trials of varenicline showed that varenicline recruits smokers into abstinence following the target quit date to a greater extent than placebo (point prevalence abstinence increased from 32% [95% confidence interval 25% to 40%] in week two to 54% [95% confidence interval 48% to 61%] in week 12). A higher immediate relapse rate following varenicline treatment discontinuation was also observed, which implied that there would be smokers who would benefit from a longer course of treatment.
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Malkus, Amy J. "Relapse Prevention Manual." Digital Commons @ East Tennessee State University, 2002. https://dc.etsu.edu/etsu-works/4700.

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Caravati, Paula Ciavarella. "Obesity Relapse in Women." Diss., Virginia Tech, 2001. http://hdl.handle.net/10919/26817.

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Obesity and relapse after dieting pose a significant threat to an increasing number of adults in this country. Resistance to treatment and high relapse rates make this problem frustrating for patients and practitioners. There is limited research on relapse causation; research on social and life circumstance factors is uncommon. Given the limitations of existing research, the purpose of this study was to investigate the natural course of obesity relapse. A purposive sample of eight obese women, ages 31-57, was selected. All of the women relapsed at least one or more times throughout their lives. A qualitative study design was used to examine and integrate their attributions for relapse. The qualitative paradigm was selected because it allowed for an inclusive study of relapse without confining the investigation to a predetermined set of responses. Information was gathered on contributory factors: physical, social and psychological, but not limited to these areas. These factors were reported in a case study format. Verbatim quotes were used to provide descriptive information and insight into individual cases. Cases were analyzed for main attributions; key words and phrases were used to develop categories. Common themes were derived from these categories and examined across the cases. Conventional wisdom about the factors, which contribute to obesity relapse, was challenged by this research study. Excess calories and decreased physical activity were not the only conditions that were contributory to the respondentsâ relapses. Diverse social and psychological issues often combined with physical factors to dominate the respondentsâ attributions. The relapse attribution themes commonly represented in the case studies included: the impact of food restriction, the impact of having personal choice taken away, negative emotions, physiological factors, lifestyle demands and the return to familiar food habits. Based on this study, it is recommended that obesity practitioners consider assessment and treatment modalities that are holistic. A paradigm shift away from traditional approaches may be a necessary step in providing more effective treatment. Additional research, which focuses on life circumstances and obesity relapse, is needed.<br>Ph. D.
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Klein, Jeffery Lane. "Attributional style and alcoholic relapse /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 1997. http://wwwlib.umi.com/cr/ucsd/fullcit?p9804031.

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Bowersox, Nicholas W. "Treatment Attrition and Relapse Readmission in Psychiatric Inpatients: Predictors of Treatment Engagement and Psychiatric Relapse." [Milwaukee, Wis.] : e-Publications@Marquette, 2009. http://epublications.marquette.edu/dissertations_mu/18.

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Paseman, Wallace W. "Relapse Prevention Using Mobile Electronic Media." Thesis, State University of New York Empire State College, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10278346.

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Morrison, Fraser. "Predictors of relapse in alcohol dependence." Thesis, University of Edinburgh, 2008. http://hdl.handle.net/1842/24999.

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Relapse rates following treatment for alcohol dependence are high, and efforts to prevent relapse are an integral part of treatment. Outcome studies have reported relapse rates of 65% within one year of treatment, with the majority relapsing within less than three months. Many factors have been studied as potential predictors of relapse in alcohol dependence, such as psychiatric disorder. Fifty four residents in an inpatient alcohol detoxification unit were tested on measures of memory and executive functioning, mood, self efficacy, quality of life, and liver function at the end of a seven to ten day stay in the unit. These patients were then followed up three months later via a telephone interview to ascertain the number of days drinking alcohol during this period. The sample of the study contained individuals at the severe end of the range of alcohol dependence, a group that has been largely neglected throughout the literature. Low mood during detoxification was found to predict number of days drinking in the three months following discharge. Executive dysfunction was also associated with relapse to a lesser extent. Low mood appears to be a significant barrier to ability to remain abstinent from alcohol following a period of detoxification. Interventions to reduce depression may have a beneficial effect in reducing relapse rates in individuals at the severe end of the range of alcohol dependence.
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Ramo, Danielle Elizabeth. "Developmental models of substance abuse relapse." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2008. http://wwwlib.umi.com/cr/ucsd/fullcit?p3297587.

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Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2008.<br>Title from first page of PDF file (viewed April 28, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references.
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Byrne, Susan Mary. "Weight maintenance and relapse in obesity." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393355.

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Gumley, Andrew Ian. "Psychological aspects of relapse in schizophrenia." Thesis, University of Stirling, 2002. http://hdl.handle.net/1893/12115.

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Following a review of the relevant literature a Cognitive Behavioural treatment protocol for the prevention of relapse in schizophrenia is presented. This treatment protocol is investigated in a 12-month non-blind randomised controlled trial comparing Cognitive Behavioural Therapy and Treatment as Usual (CBT + TAU) versus Treatment as Usual (TAU) alone. Three studies of treatment outcome are described: relapse and admission, remission and social functioning, and psychological distress. 144 participants with a DSM-IV Schizophrenia spectrum disorder were randomised to receive either CBT + TAU (n = 72) or TAU alone (n = 72). 11 participants dropped out (6 from CBT + TAU, 5 from TAU alone) leaving a completers sample of 133. Participants were assessed at entry, 12-weeks, 26-weeks, and 52 weeks. CBT was delivered over two stages: a 5-session engagement phase which was provided between entry and 12-weeks, and a targeted CBT phase which was delivered on the appearance of early signs of relapse. Over 12-months CBT + TAU was associated with significant reductions in relapse and admission rate. The clinical significance of the reduced relapse and admission rate amongst the CBT + TAU group was investigated. First, receipt of CBT + TAU was associated with improved rates of remission over 12-months. Second, clinically significant improvements in social functioning were investigated. Again, receipt of CBT + TAU was associated with clinically significant improvements in prosocial activities. However, receipt of CBT + TAU was not associated with improvements in psychological distress over 12-months. The theory underpinning the cognitive behavioural treatment protocol predicted that negative appraisals of self and psychosis represent a cognitive vulnerability to relapse. This hypothesis was investigated during the present 2 Abstract study. After controlling for clinical, treatment and demographic variables, negative appraisals of self and entrapment in psychosis were associated with increased vulnerability to relapse, whilst negative appraisals of self were associated with reduced duration to relapse. Finally, an explorative study of changes in negative appraisals of psychosis and self over time, which were associated with relapsers versus non-relapsers from the TAU alone group, was conducted. This study found a strong association between the experience of relapse, increasing negative appraisals of psychosis and self, and the development of psychological co-morbidity in schizophrenia. Results of treatment outcome and theoretical analyses are discussed in terms of their relevance to the further development of psychological models and treatments for psychosis.
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Books on the topic "Relapse"

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Abuse, National Institute on Drug. Introducing relapse prevention. [Rockville, Md.?]: National Institutes of Health ; National Institute on Drug Abuse, 1993.

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Turner, Nikki. Relapse: A novel. New York: One World Trade Paperbacks-Ballantine Books, 2010.

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National Institute on Drug Abuse. Introducing relapse prevention. [Rockville, Md.?]: National Institutes of Health ; National Institute on Drug Abuse, 1993.

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National Institute on Drug Abuse. Introducing relapse prevention. [Rockville, Md.?]: National Institutes of Health ; National Institute on Drug Abuse, 1993.

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Richards, C. Steven, and Michael G. Perri, eds. Relapse prevention for depression. Washington: American Psychological Association, 2010. http://dx.doi.org/10.1037/12082-000.

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Jon, Carlson, American Psychological Association, and Governors State University. Division of Digital Learning and Media Design, eds. Relapse prevention over time. Washington, D.C: American Psychological Association, 2007.

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1948-, Gossop Michael, ed. Relapse and addictive behaviour. London: Tavistock/Routledge, 1989.

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Richards, C. Steven. Relapse prevention for depression. Washington, DC: American Psychological Association, 2010.

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Steven, Richards C., Perri Michael G, and American Psychological Association, eds. Relapse prevention for depression. Washington, DC: American Psychological Association, 2010.

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Association, American Psychological, ed. Relapse prevention for depression. Washington, DC: American Psychological Association, 2010.

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Book chapters on the topic "Relapse"

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Lustyk, M. Kathleen B., and Gabriana Navarrete. "Relapse, Relapse Prevention." In Encyclopedia of Behavioral Medicine, 1864–66. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-39903-0_276.

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Molina, Kristine M., Kristine M. Molina, Heather Honoré Goltz, Marc A. Kowalkouski, Stacey L. Hart, David Latini, J. Rick Turner, et al. "Relapse, Relapse Prevention." In Encyclopedia of Behavioral Medicine, 1638–40. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4419-1005-9_276.

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Lustyk, M. Kathleen B., and Gabriana Navarrete. "Relapse, Relapse Prevention." In Encyclopedia of Behavioral Medicine, 1–3. New York, NY: Springer New York, 2020. http://dx.doi.org/10.1007/978-1-4614-6439-6_276-2.

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Melemis, Steven M. "Relapse and Relapse Prevention." In Alcohol Use: Assessment, Withdrawal Management, Treatment and Therapy, 349–61. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-18381-2_22.

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Floresco, Stan, Robert Kessler, Ronald L. Cowan, Robert Kessler, Ronald L. Cowan, Mark Slifstein, Andrea Cipriani, et al. "Relapse." In Encyclopedia of Psychopharmacology, 1152. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-540-68706-1_544.

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Erb, Suzanne, and Franca Placenza. "Relapse." In Animal Models of Drug Addiction, 461–79. Totowa, NJ: Humana Press, 2010. http://dx.doi.org/10.1007/978-1-60761-934-5_17.

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Milhorn, H. Thomas. "Relapse." In Substance Use Disorders, 243–52. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-63040-3_17.

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Bruijn, Brian D., and Lucy L. Bruijn. "Relapse." In Working with the Human Trafficking Survivor, 143–53. 1 Edition. | New York : Routledge, 2018.: Routledge, 2019. http://dx.doi.org/10.4324/9781315684468-9.

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Hsu, Sharon Hsin, and G. Alan Marlatt. "Addiction syndrome: Relapse and relapse prevention." In APA addiction syndrome handbook, Vol. 2: Recovery, prevention, and other issues., 105–32. Washington: American Psychological Association, 2012. http://dx.doi.org/10.1037/13750-005.

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O’Hara, Peggy. "Relapse Prevention." In The Clinical Management of Nicotine Dependence, 310–19. New York, NY: Springer New York, 1991. http://dx.doi.org/10.1007/978-1-4613-9112-8_25.

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Conference papers on the topic "Relapse"

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Tripathi, Mukesh Kumar, Meka Ananya, V. N. L. N. Murthy, Tumma Shashank, Jale Subash Reddy, and Kaushal Attaluri. "Enhanced Breast Cancer Relapse Prediction using Ensemble Learning Techniques." In 2024 4th International Conference on Sustainable Expert Systems (ICSES), 918–23. IEEE, 2024. https://doi.org/10.1109/icses63445.2024.10763119.

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Khatri, Radhika, Faryal Khan, and Shah Jamal Alam. "Risk Identification and Relapse Prediction in Lung Adenocarcinoma (LUAD)." In 2024 International Conference on Artificial Intelligence, Metaverse and Cybersecurity (ICAMAC), 1–6. IEEE, 2024. https://doi.org/10.1109/icamac62387.2024.10828988.

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Yasin, Sana, Imran Raza, Alice Othmani, and Syed Asad Hussain. "AI-Enabled Electroencephalogram (EEG) Analysis for Depression Relapse Detection in Quadriplegic Patients." In 2024 International Conference on Computing, Internet of Things and Microwave Systems (ICCIMS), 1–6. IEEE, 2024. http://dx.doi.org/10.1109/iccims61672.2024.10690640.

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Daw, S., and K. Kelly. "Relapse treatments." In ISCAYAHL 2020. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1701866.

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Tent, Michiel. "A pre-relapse immune signature implicates EBV reactivation in MS relapse." In ACTRIMS Forum 2025, edited by Rachel Giles. Baarn, the Netherlands: Medicom Medical Publishers, 2025. https://doi.org/10.55788/24c5a367.

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Murnane, Elizabeth L., and Scott Counts. "Unraveling abstinence and relapse." In CHI '14: CHI Conference on Human Factors in Computing Systems. New York, NY, USA: ACM, 2014. http://dx.doi.org/10.1145/2556288.2557145.

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Alrahamneh, H., A. E. Orellana, and A. Arzabala. "Chronic Eosinophilic Pneumonia Relapse." In American Thoracic Society 2023 International Conference, May 19-24, 2023 - Washington, DC. American Thoracic Society, 2023. http://dx.doi.org/10.1164/ajrccm-conference.2023.207.1_meetingabstracts.a3229.

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Cruz, Marta Arnáez De La, Victor Lago, Sandra Florez Herrero, Pablo Padilla-Iserte, Luis Matute, Marta Gurrea, and Raquel Quintana. "#618 Multicenter analysis of the relapse pattern and treatment in relapsed endometrial cancer." In ESGO 2023 Congress. BMJ Publishing Group Ltd, 2023. http://dx.doi.org/10.1136/ijgc-2023-esgo.354.

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Yang, Zhou, Long H. Nguyen, and Fang Jin. "Opioid relapse prediction with GAN." In ASONAM '19: International Conference on Advances in Social Networks Analysis and Mining. New York, NY, USA: ACM, 2019. http://dx.doi.org/10.1145/3341161.3342951.

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Daboussi, Selsabil, Améni Naaroura, Samira Mhamdi, Safa Marzouki, Houda Snoussi, Chiraz Aichaouia, and Zied Moetemri. "Predictors of pulmonary tuberculosis relapse." In ERS International Congress 2023 abstracts. European Respiratory Society, 2023. http://dx.doi.org/10.1183/13993003.congress-2023.pa2043.

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Reports on the topic "Relapse"

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Hashim, Zia, Alok Nath, Mansi Gupta, Ajmal Khan, Ajit Kumar Jha, and Anup Kumar. Sarcoidosis Relapse: Systematic Review and Metanalysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2023. http://dx.doi.org/10.37766/inplasy2023.8.0056.

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Karadeniz, Meltem. The hunt for a signature of MS relapse. Edited by Suzannah Lyons. Monash University, September 2024. http://dx.doi.org/10.54377/59b7-2eef.

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Conway, Terry L. Improving Navy Women's Health: Preventing Smoking Relapse After Recruit Training. Fort Belvoir, VA: Defense Technical Information Center, March 1999. http://dx.doi.org/10.21236/ada370229.

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Buckley, Jonathan D. Predicting Time-to-Relapse in Breast Cancer Using Neural Networks. Fort Belvoir, VA: Defense Technical Information Center, October 1995. http://dx.doi.org/10.21236/ada300396.

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Zhou, Dongdong. Non-pharmacological interventions in relapse prevention of unipolar depression: a network meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2020. http://dx.doi.org/10.37766/inplasy2020.4.0072.

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Hanlon, Alexandra L. Hierarchical Nonlinear Mixed Effect Modeling: Defining Post-radiation Therapy Relapse in Prostate Cancer Patients. Fort Belvoir, VA: Defense Technical Information Center, July 2004. http://dx.doi.org/10.21236/ada432448.

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Hanlon, Alexandra L. Hierarchical Nonlinear Mixed Effect Modeling: Defining Post-Radiation Therapy Relapse in Prostate Cancer Patients. Fort Belvoir, VA: Defense Technical Information Center, July 2002. http://dx.doi.org/10.21236/ada413285.

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Hanlon, Alexandra L. Hierarchical Nonlinear Mixed Effects Modeling: Defining Post-Radiation Therapy Relapse in Prostate Cancer Patients. Fort Belvoir, VA: Defense Technical Information Center, July 2003. http://dx.doi.org/10.21236/ada418391.

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Boyland, Latoria, Kara Darretta, and Keevia Porter. Long-Acting Antipsychotic Injectables vs. Oral Antipsychotics: Comparing Compliance, Relapse, and Re-Hospitalization Rates. University of Tennessee Health Science Center, April 2022. http://dx.doi.org/10.21007/con.dnp.2022.0037.

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Sobell, Mark B., Alan Peterson, Linda C. Sobell, Christopher Hunter, and Christine Hunter. Facilitating Smoking Cessation and Preventing Relapse in Primary Care: Minimizing Weight Gain by Reducing Alcohol. Fort Belvoir, VA: Defense Technical Information Center, January 2009. http://dx.doi.org/10.21236/ada500902.

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