الفهرس 
Introduction
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Abstract
This retrospective study was performed to evaluate treatment outcome and toxicities of different treatment modalities of relapsed and refractory adult NHL in Clinical Oncology department, Assiut University Hospital between 2011 and 2015
We identified 217 patients with relapsed and refractory NHL. The median age was 50 years. There were 101 males (46.5%) and 116 females (53.5%). The Eastern Cooperative Oncology group performance status (PS) 0 was identified in 25 patients (11.5%) and PS 1 and 2 were identified in 112 (51.6%) and 80 (36.9%) patients respectively. One hundred thirty three patients (61.3%) had B symptoms. The majority of the patients had B-NHL (85.3%) and 32 patients (14.7%) had T-NHL.
The stage of disease according to Ann Arbor staging was as follow: stage I 12(5.6%), stage IIA 40 (18.4%), stage IIB 7 (3.2%)stage IIIA 78 (35.9%), stage IIIB 41 (18.9%) and stage IV 39 (18%). The initial treatment modality (first-line therapy) was CHOP in 200 patients (92.2%) and R-CHOP in 17 (7.8%).
The overall response rates were higher in patients received DHAP (62.9%) than the other lines of treatment, but the difference wasn’t significant. P value =0.22.
Hematological toxicity was most common in patients who had received CHOP but the difference between different lines of treatment weren’t significant p value= 0.95
The 3 year OS rates were 54.8%, and the 3 year PFS rates were 49.3%, with median survival time of 40 months and median time to relapseof 10 monthsp value=0.917
So we conclude that the different treatment modalities of relapsed and refractory NHL didn’t show prolonged survival rate, so it must be followed by bone marrow transplantation for eligible patients.